经胸乳入路腔镜与颈部入路常规手术对甲状腺良性肿瘤效果  

The Effect of Transthoracic Approach and Conventional Cervical Approach Surgery on Benign Thyroid Tumors

作　　者：宋聪睿 王勇[1] 高阳[1] 李烜 SONG Cong-rui;WANG Yong;GAO Yang;LI Xuan(General Surgery,North Campus,Peking University Third Hospital,Beijing 100089,China)

机构地区：[1]北京大学第三医院北方院区综合外科,北京100089

出　　处：《医学信息》2020年第17期106-108,共3页Journal of Medical Information

摘　　要：目的观察经胸乳入路腔镜与颈部入路常规手术治疗甲状腺良性肿瘤的效果。方法选取2016年9月~2019年9月我院接诊的100例甲状腺良性肿瘤患者为研究对象,采用随机数字表法分为常规组和观察组,各50例。常规采用颈部入路常规手术治疗,观察组采用经胸乳入路腔镜治疗,比较两组肿瘤切除率、手术指标(手术时间、术中出血量、术后疼痛度、术后切口引流量)、甲状腺功能指标[促甲状腺激素(TSH)、甲状腺素(T4)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)]、甲状旁腺功能指标[甲状旁腺激素(PTH)]、血钙水平、并发症发生率以及美观满意度评分。结果观察组肿瘤切除率为98.00%,与常规组的96.00%比较,差异无统计学意义(P>0.05);观察组手术时间长于常规组,术中出血量、术后疼痛度、术后切口引流量均小于常规组(P<0.05);术后两组TSH、T4、FT3水平均低于术前,FT4均高于术前(P<0.05),但观察组TSH、T4、FT3、FT4与常规组比较,差异无统计学意义(P>0.05);两组术后PTH水平均高于术前、血钙水平均低于术前(P<0.05),但观察组与常规组比较(P>0.05);观察组并发症发生率为2.00%,低于常规组的8.00%(P<0.05);观察组美观满意度评分高于常规组(P<0.05)。结论经胸乳入路腔镜与颈部入路常规手术治疗甲状腺良性肿瘤均可获得较理想的效果,对甲状腺和甲状旁腺功能影响基本相似。但是前者术中出血量少,术后疼痛度轻、引流量少,对患者创伤小,术后并发症少,利于患者康复,且瘢痕小,可获得较高的美观满意度。Objective To observe the effect of transthoracic approach and conventional cervical approach in the treatment of benign thyroid tumors.Methods A total of 100 patients with benign thyroid tumors admitted to our hospital from September 2016 to September 2019 were selected as the research objects.They were divided into the routine group and the observation group by random number table method,with 50 cases in each group.Routine neck approach was used for conventional surgical treatment,and the observation group was treated with transthoracic approach endoscopic treatment.The tumor resection rate and surgical indicators(operating time,intraoperative blood loss,postoperative pain,postoperative incision drainage volume were compared between the two groups),thyroid function indexes[thyroid stimulating hormone(TSH),thyroxine(T4),free thyroxine(FT4),free triiodothyronine(FT3)],parathyroid function indexes[parathyroid hormone(PTH)],blood calcium level,complication rate and aesthetic satisfaction score.Results The tumor resection rate in the observation group was 98.00%,compared with 96.00% in the conventional group,the difference was not statistically significant(P>0.05);the operation time in the observation group was longer than that in the conventional group,intraoperative blood loss,postoperative pain,postoperative incision induction the flow rate was less than that of the conventional group(P<0.05);the levels of TSH,T4,and FT3 in the two groups after surgery were lower than those before surgery,and FT4 was higher than that before surgery(P<0.05),but the observation group TSH,T4,FT3,FT4 compared with the conventional group,the difference was not statistically significant(P>0.05);The postoperative PTH levels of the two groups were higher than preoperatively,and the blood calcium levels were lower than preoperatively(P<0.05),but the observation group was compared with the routine group(P>0.05);complications occurred in the observation group rate was 2.00%,which was lower than 8.00% of the conventional group(P<0.05);the aes

关 键 词：经胸乳入路腔镜 颈部入路 甲状腺良性肿瘤 并发症 

分 类 号：R736.1[医药卫生—肿瘤]