改良经胸入路腔镜甲状腺切除术的临床效果及安全性研究  

Clinical analysis of the safety and clinical outcome of modified endoscopic thyroidectomy via transthoracic approach

作　　者：李全 张景华 宋冀涛 杨小华 Li Quan;Zhang Jinghua;Song Jitao;Yang Xiaohua(Department of General Surgery,the 2nd Branch of Huayou General Hospital,Renqiu,Hebei 062552,China)

机构地区：[1]华油总医院二部医院普通外科,河北任丘062552

出　　处：《中华普外科手术学杂志（电子版）》2021年第1期73-76,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：河北省自然科学基础研究计划(2018JM7067);华北油田矿区医疗卫生临床新技术应用研究(2019-HB-G0203)。

摘　　要：目的探究经胸入路腔镜甲状腺切除术中不使用膨胀剂的临床效果。方法将2017年6月至2019年12月接受腔镜下甲状腺切除术的100例患者采用随机数字法分为两组,每组50例。膨胀液组使用膨胀液来建立手术操作空间,剥离器组采用自制改良皮下剥离器。使用统计学软件SPSS 24.0分析,围手术期指标、生命体征、疼痛评分等计量资料采用(x±s)表示,组间比较采用独立样本t检验;术后并发症等计数资料采用χ^2检验。P<0.05为检验标准。结果两组患者均成功完成手术,无术中并发症。剥离器组在手术用时、引流时间及引流量均优于膨胀液组(P<0.05);在术中出血量、住院时间、生命体征变化、术后6 h、12 h及24 h的疼痛评分的比较中,两组间差异均无统计学意义(P>0.05)。剥离器组术后并发症发生率为12%,明显少于膨胀液组28%(P<0.05)。结论腔镜下经胸入路甲状腺切除术不使用膨胀剂安全可行,且能显著减少手术时间,可在临床推广。Objective To investigate the safety and clinical outcome of modified endoscopic thyroidectomy via transthoracic approach without expandsion.Methods A total of 100 patients who received endoscopic thyroidectomy were enrolled into present study,including 50 cases in the expansion fluid group and 50 cases in the stripper group.Patients in the expansion fluid group were treated by using expansion fluid,while patients in the stripper group were treated by using stripper without expansion fluid.SPSS 24.0 software were used for statistical analysis.Measurement data such as perioperative indexes、indexes of vital signs、pain scores were expressed as (x±s) and were analyzed by using independent sample t test.Count data such as postoperative complications were analyzed by usingχ^2 test.A P value of<0.05 was considered as statistically significant difference.Results Patients in both two groups receiced successful operation,without intraoperative complications.The operation time、drainage time and volume in the stripper group were better those that of the expansion fluid group respectively(P<0.05).There were no statistically significant differences between the two groups in terms of intraoperative blood loss,length of hospital stay,changes in vital signs before and after the establishment of endoscopic space,pain scores at 6h,12h and 24h after surgery(P>0.05).The incidence of postoperative complications of 12%in the stripper group was significantly better than 28%in the expansion fluid group(P<0.05).Conclusion Endoscopic transthoracic thyroidectomy without expandsion fluid is safe and feasible,and could significantly reduce the operation time,which is worthy of clinical promotion.

关 键 词：胸腔镜 甲状腺切除术 膨胀液 治疗结果 

分 类 号：R47[医药卫生—护理学]