腔镜下辅助小切口甲状腺切除术治疗甲状腺腺瘤的临床研究  

Clinical study of endoscope aided small incision thyroidectomy in the treatment of thyroid adenoma

作　　者：任旋磊 沙洪存 张四海 郝龙 洪晓明 

机构地区：[1]宁波市鄞州区第二医院普外科,浙江宁波315100

出　　处：《中国现代医生》2017年第5期75-78,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2015KYA205)

摘　　要：目的研究腔镜下辅助小切口甲状腺切除术治疗甲状腺腺瘤的优势。方法选择2014年1月-2016年1月我院住院治疗的52例甲状腺腺瘤患者作为观察对象,采用随机数字表法根据治疗方法不同随机分为研究组(腔镜下辅助小切口甲状腺切除术)和对照组(采用开放性手术)。每组26例,比较两组患者苕项手术观察指标及术后疼痛程度、并发症发生率。结果研究组的手术切口长度(2.5±0.3)cm,手术时间(40.5±11.2)min,术中出血量(41.2±17.3)mL,术后颈部恢复活动时间(39.+2±12.7)h,术后住院时间(6.4±1.3)d,分别与对照组开放性手术比较,差异具有统计学意义(P<0.05)。研究组患者苏醒时VAS评分为(6.32±1.16)分、对照组患者苏醒时VAS评分为(8.78+2.11)分,研究组患者苏醒时VAS评分显著低于对照组,差异具有统计学意义(P<0.05);研究组患者术后6、12、24h的VAS评分分别显著低于对照组、差异具有统计学意义(P<0.05);研究组患者术后并发症发生率合计为7.69%、显著低于对照组患者术后并发症发生率,差异具有统计学意义(P<0.05)。结论腔镜下辅助小切口甲状腺切除术治疗甲状腺腺瘤较开放性手术具有切口小、术后疼痛轻、并发症少、术后恢复快等优点、值得推广和应用。Objective To study the advantages of endoscope aided small incision thyroidectomy in the treatment of thy- roid adenoma. Methods 52 patients with thyroid adenoma who were hospitalized in our hospital from January 2014 to January 2016 were selected as observation subjects. They were randomly divided into the study group （endoscope aided small incision thyroidectomy） and the control group（open surgery） by a random number method according to different treatment methods, with 26 patients in each group. The surgical observation indicators and postoperative pain, the inci- dence of complications were compared between the two groups. Results The operative incision length was（2.5±0.3） cm in the study group, and the surgery time was（40.5± 11.2） minutes, the i ntraoperative blood loss was （41.2± 17.3） mL, the postoperative neck recovery time was（39.2±12.7） h, and the postoperative length of stay was（6.4±1.3）d. Compared with the control group receiving open surgery, the difference was significant（P〈0.05）. The VAS score upon awakening was （6.32＋1.16） in the study group and（8.78＋2.11） in the control group. The VAS score in the study group was significantly lower than that in the control group, the difference was significant （P〈0.05）; The VAS scores in the study group were sig- nificantly lower than those in the control group at 6, 12 and 24 hours after operation, the difference was significant（P〈 0.05）; the incidence rate of postoperative complications was 7.69% in the study group, which was significantly lower than that in the control group, the difference was significant（P〈0.05）. Conclusion Endoscope aided small incision thy- roidectomy in the treatment of thyroid adenoma has the advantages of small incision, low postoperative pain, less com- plications, quick recovery, which is worthy of popularization and application.

关 键 词：腔镜下辅助小切口甲状腺切除术 甲状腺腺瘤 疼痛 并发症 

分 类 号：R730.51[医药卫生—肿瘤]