内镜甲状腺手术不同入路对分离皮瓣面积、并发症和相应损伤的影响  

Different surgical approaches of endoscopic thyroidectomy for patients with separation of flap size,complications and the corresponding damage

作　　者：李辉[1] 陈涛[1] 

机构地区：[1]北京市大兴区人民医院普外科,北京102600

出　　处：《局解手术学杂志》2016年第3期171-174,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨内镜经腋窝单孔径路甲状腺手术(TASPET)与内镜双乳晕同侧腋窝径路甲状腺手术(BBIAA)对分离皮瓣面积大小、并发症和相应损伤的影响。方法选取2013年2月至2015年4月在我院行BBIAA和TASPET治疗的72例甲状腺疾病患者作为研究对象,按照手术方法不同,分为BBIAA组和TASPET组各36例,比较内镜甲状腺手术不同入路对分离皮瓣面积大小、并发症和相应的损伤影响。结果 TASPET组平均分离皮瓣面积大于BBIAA组,差异有统计学意义(P<0.01);BBIAA组术后VAS评分(0.24±0.39)分低于TASPET组(1.85±1.37)分,差异具有统计学意义(P<0.01);BBIAA组术后无并发症产生,TASPET组术后有10例产生并发症,差异具有统计学意义(P<0.01)。结论 BBIAA手术时间短,分离皮瓣面积小,无并发症发生,甲状旁腺及神经损伤较小,具有较高的安全性和理想的美容效果。Objective To explore the effect of trans-axillary single-port and bilateral breast of ipsilateral axillary approach in endoscopic thyroidectomy on area of skin flap,complications and the corresponding impact damage. Methods A total of 72 patients who were underwent either BBIAA or TASPET in our hospital from February 2013 to April 2015,were divided into BBIAA group and TASPET group,each group had 36 cases. The area of skin flap,complications and the corresponding impact damage between two surgical methods were compared. Results The average separation of the flap area in TASPET group was significantly higher than that in BBIAA group（ P〈0. 01）. The VAS score of BBIAA group was（ 0. 24 ± 0. 39） point,which was lower than（ 1. 85 ± 1. 37） point of TASPET group,the difference was significant（ P 〈0.01）. The patients of BBIAA group had no complications,while there were 10 patients suffered complications in TASPET group,and the difference of postoperative complications was significant（ P〈0. 01）. Conclusion Bilateral breast and ipsilateral axillary approach have the advantage of less operative time,smaller separation of the flap area,lower complication incidence and less damage on parathyroid gland and nerve,which had an ideal safety and cosmetic result.

关 键 词：甲状腺 内镜手术 双乳晕同侧腋窝径路 内镜经腋窝单孔径路甲状腺手术 

分 类 号：R653[医药卫生—外科学]