3D辅助经口腔镜甲状腺癌根治手术的单盲随机对照研究  

Single-blind randomized controlled comparison of 3D and 2D assistive functions in transoral endoscopic thyroid surgery

作　　者：杜健[1] 王平[2] Du Jian;Wang Ping(Department of General Surgery,Seventh Clinical College,China Medical University,Fushun 113006,China;Department of Thyroid Surgery,Second Affiliated Hospital of Zhejiang University,School of Medicine,Hangzhou 310009,China)

机构地区：[1]辽宁省健康产业集团抚矿总医院(中国医科大学第七临床学院)普外科一,抚顺113006 [2]浙江大学医学院附属第二医院甲状腺外科,杭州310009

出　　处：《中华内分泌外科杂志》2020年第1期8-12,共5页Chinese Journal of Endocrine Surgery

基　　金：浙江省基础公益研究计划(LGF18H160002);国家自然科学基金(21434006)。

摘　　要：目的探究3D和2D辅助功能在经口腔镜甲状腺癌根治手术中的临床应用价值。方法回顾性分析2018年5月至2019年4月在浙江大学医学院附属第二医院甲状腺外科行经口腔镜甲状腺癌手术患者的临床资料,依据手术方式分为3D组和2D组,每组各30例。采用SPSS 20.0统计软件分析数据,包括手术时间、术后住院时间、清扫淋巴结数量、术后并发症发生率等,两组计量资料采用t检验或Wilcoxon检验;计数资料采用McNemar配对χ^2检验。结果2组在人口基线特征比较差异无统计学意义(P>0.05),3D组和2D组术中指标比较,包括手术时间(118.20±19.50 vs 123.90±18.20)min、术中出血量(8.00±3.00 vs 8.90±2.60)ml、清扫淋巴结数量(8.20±3.30 vs 8.40±2.90)枚和淋巴结转移率(40.0%vs 33.3%),差异无统计学意义,喉返神经麻痹(0.0%vs 3.3%)、暂时性低钙血症(0.0%vs 3.3%)发生概率3D组要略低于2D组,差异无统计学意义。术后指标比较,包括术后住院时间(2.90±0.85 vs 2.87±0.82)d、术后24 h引流量(58.00±19.50 vs 61.50±16.10)ml、疼痛评分(1.30±0.60 vs 1.20±0.60)分和患者满意度评分(8.90±0.70 vs 8.80±0.60)分,2组差异无统计学意义。结论3D辅助运用于经口腔镜甲状腺手术中切实可行,熟练掌握后可能有益于降低手术时间,减少术后并发症发生率,值得临床进一步推广。Objective To explore the clinical value of 3D and 2D assistive functions in transoral endoscopic thyroid surgery.Methods The clinical data of patients of transoral thyroid surgery from May.2018 to Apr.2019 were retrospectively collected.According to the surgical procedure,they were divided into 3D group and 2D group,30 cases in each group.Data were analyzed by SPSS 20.0 statistical software,including operation time,postoperative hospital stay,number of lymph nodes removed,postoperative complication rate,etc.The two groups were measured by t test or Wilcoxon test.The count data were analyzed by McNemar paired χ^2 test.Results There was no significant difference between the two groups in the baseline characteristics of the population(P>0.05).There was also no significant difference in the intraoperative indexes including the operation time[(118.20±19.50 vs 123.90±18.20)min],the intraoperative blood loss[(8.00±3.00 vs 8.90±2.60)ml],the number of lymph nodes removed(8.20±3.30 vs 8.40±2.90),and the lymph node metastasis rate(40.0%vs 33.3%).The incidence of recurrent laryngeal nerve paralysis(0.0%vs 3.3%)and transient hypocalcemia(0.0%vs 3.3%)were slightly lower in the 3D group,though there was no statistical difference.There was no significant difference in the postoperative index comparisons,including postoperative hospital stay[(2.90±0.85 vs 2.87±0.82)Days],24-hour postoperative drainage[(58.00±19.50 vs 61.50±16.10)ml],pain scores(1.30±0.60 vs 1.20±0.60),and patient satisfaction scores(8.90±0.70 vs 8.80±0.60).Conclusions 3D assisted operation is feasible in transoral endoscopic thyroid surgery.It may be beneficial to the reduction of the operation time as well as incidence of postoperative complications,and may be worthwhile to promote for further clinical application.

关 键 词：3D辅助 腔镜甲状腺 甲状腺癌 经口 随机对照 

分 类 号：R653[医药卫生—外科学] R736.1[医药卫生—临床医学]