无充气经锁骨下入路腔镜甲状腺术与传统开放甲状腺术治疗甲状腺病变的临床效果  

Clinical efficacy of non inflatable subclavian endoscopic thyroidectomy and traditional open thyroidectomy in the treatment of thyroid lesions

作　　者：王文卿 余永青 陈晶 WANG Wenqing;YU Yongqing;CHEN Jing(Department of General Surgery,Jingdezhen Third People's Hospital,Jingdezhen,Jiangxi 333000,China)

机构地区：[1]江西省景德镇市第三人民医院普外科,江西景德镇333000

出　　处：《检验医学与临床》2024年第3期388-392,共5页Laboratory Medicine and Clinic

基　　金：江西省卫生健康委委员会科技计划项目(202311676)。

摘　　要：目的比较无充气经锁骨下入路腔镜甲状腺术与传统开放甲状腺术治疗甲状腺病变的临床效果。方法选择该院2022年1至2023年4月收治的甲状腺手术患者73例作为研究对象,按照随机分组原则将其分为传统组(36例)和腔镜组(37例)。传统组采用传统开放甲状腺手术进行治疗,腔镜组采用无充气经锁骨下入路腔镜甲状腺手术进行治疗。比较两组患者手术相关指标水平,包括手术时间、术中失血量、术后引流量及引流管拔除时间、术后住院时间、淋巴结清扫总数及阳性淋巴结数,术后2 d、7 d、1个月、3个月切口视觉模拟评分法(VAS)评分,术后并发症发生情况及术后3个月对美容效果的满意度。结果腔镜组患者手术时间长于传统组,术中失血量低于传统组,术后引流量高于传统组,差异均有统计学意义(P<0.05);但两组患者术后引流管拔除时间、淋巴结清扫总数、阳性淋巴结数、术后住院时间比较,差异均无统计学意义(P>0.05);重复测量方差分析结果显示,两组患者术后2 d、7 d、1个月及3个月切口VAS评分存在组间、时间及交互效应(P<0.05),且腔镜组术后2 d、7 d、1个月及3个月切口VAS评分均低于传统组,差异均有统计学意义(P<0.05);腔镜组与传统组患者术后并发症率比较(8.11%vs.11.11%),差异无统计学意义(P>0.05);腔镜组对美容效果的满意度高于传统组,差异有统计学意义(P<0.05)。结论无充气经锁骨下入路腔镜甲状腺术与传统开放甲状腺术均是安全、可靠的治疗手段,且无充气经锁骨下入路腔镜甲状腺术术中失血量少、术后疼痛程度低、舒适度及美观度高,值得临床推广应用。Objective To compare the clinical efficacy of non inflatable subclavian endoscopic thyroidectomy and traditional open thyroidectomy in the treatment of thyroid lesions.Methods A total of 73 patients with thyroid surgery admitted to the hospital from January 2022 to April 2023 were selected as the study subjects and randomly divided into the traditional group(36 cases)and the endoscopic group(37 cases)according to the principle of random grouping.The traditional group was treated with traditional open thyroid ectomy,while the endoscopic group was treated with non inflatable subclavian endoscopic thyroid.The surgical related indicators,including surgery time,intraoperative blood loss,postoperative drainage volume and drainage tube removal time,postoperative hospital stay,total number of lymph node dissection and number of positive lymph nodes,visual analogue scale(VAS)scores at 2 d,7 d,1 month and 3 months after surgery,postoperative complications and satisfaction degree to cosmetic effects were compared between the traditional group and the endoscopic group.Results The surgery time of the endoscopic group was longer than that of the traditional group,the intraoperative blood loss was lower than that of the traditional group,and the postoperative drainage volume was higher than that of the traditional group,the differences had statistical significance(P<0.05);however,there were no statistically significant differences in postoperative drainage tube removal time,total number of lymph node dissection,number of positive lymph nodes and postoperative hospital stay between the two groups(P>0.05).Repeated NOVA results showed that there were intergroup effect,time effect and interaction effects in the VAS scores of incisions at 2 d,7 d,1 month and 3 months after surgery in both groups(P<0.05),and the VAS scores of incision at 2 d,7 d,1 month and 3 months postoperatively in endoscopic group were lower than those in the traditional group,with statistically significant differences(P<0.05).The difference in the incidence of p

关 键 词：无充气 锁骨下入路 腔镜手术 开放手术 甲状腺 疗效比较 

分 类 号：R615[医药卫生—外科学]