腔镜下甲状腺手术的疗效与方法学  

Efficacy and methodology of endoscopic thyroid surgery

作　　者：傅朝春 徐安书 侯勇 杨晓宾 周莉花 陈永伦 FU Chaochun;XU Anshu;HOU Yong;YANG Xiaobin;ZHOU Lihua;CHEN Yonglun(Department of Gastrointestinal Surgery,Qujing Municipal First People's Hospital,Qujing Yunnan 655000,China;Department of Minimally Invasive Hepatobiliary Surgery,Qujing Municipal First People's Hospital,Qujing Yunnan 655000,China;Department of Hand microsurgery,Foot and Ankle Surgery,Qujing Municipal First People's Hospital,Qujing Yunnan 655000,China;Department of Anesthesiology,Qujing Municipal First People's Hospital,Qujing Yunnan 655000,China)

机构地区：[1]曲靖市第一人民医院胃肠外科,云南曲靖655000 [2]曲靖市第一人民医院微创肝胆外科,云南曲靖655000 [3]曲靖市第一人民医院手显微外科、足踝外科,云南曲靖655000 [4]曲靖市第一人民医院麻醉科,云南曲靖655000

出　　处：《云南医药》2024年第1期15-19,共5页Medicine and Pharmacy of Yunnan

摘　　要：目的对比经胸乳途径腔镜下甲状腺手术与传统甲状腺手术的疗效,观察患者对两种术式的认可度。方法回顾本院2019年9月-2021年1月收治的74例甲状腺良性肿瘤患者的临床资料,按手术入路分传统组(30例)和经胸乳组(44例),传统组均按传统术式完成甲状腺切除,经胸乳组均经胸乳入路行腔镜下甲状腺切除。比较2组手术耗时、术中出血量、术后引流量、住院天数、疼痛程度、并发症发生情况和手术满意度。结果2组患者均顺利完成既定手术,除术后引流量2组间无统计学差异外,经胸乳组患者的手术耗时、术中出血量、住院天数、VAS评分均优于传统组,差异有统计学意义(74.40±9.35min VS 112.20±12.45min,35±5mL VS 70±9mL,4.75±1.23d VS 10.20±1.78d,3.25±0.56 VS 6.42±1.22,P均<0.05)。传统组并发症发生率高于经胸乳组,差异有统计学意义(20.00%VS 4.55%,P<0.05)。经胸乳组患者的满意度明显高于传统组,差异有统计学意义(72.73%VS 60.00%,P<0.05)。结论与传统甲状腺切除手术比较,经胸乳组胸乳入路腔镜下甲状腺切除术式具有手术时间短、出血量少、患者恢复快、切口美观、患者满意度高等优点,值得推广应用。Objective To compare the efficacy of endoscopic thyroid surgery through the chest and breast approach and traditional thyroid surgery,and observe the patient s acceptance of the two surgical methods.Methods The clinical data of 74 patients with benign thyroid tumors admitted to our hospital from September 2019 to January 2021 were reviewed.According to the surgical approach,the patients were divided into traditional group(30 cases)and transthoracic group(44 cases).The traditional group completed thyroidectomy according to the traditional approach,while the transthoracic group performed endoscopic thyroidectomy through the breast and chest approach.Compared the surgical time,intraoperative bleeding volume,postoperative drainage volume,length of hospital stay,degree of pain,incidence of complications and surgical satisfaction between the two groups.Results Both groups of patients successfully completed the scheduled surgery.There was no statistical difference in postoperative drainage volume between the two groups.The surgical time,intraoperative blood loss,hospitalization days and VAS scores better than those in the traditional group,and the differences were statistically significant(74.40±9.35 minutes VS 112.20±12.45 minutes,35±5mL VS 70±9mL,4.75±1.23d VS 10.20±1.78 days,3.25±0.56 VS 6.42±1.22,all P<0.05).The incidence rate of complications in the traditional group was higher than that in the transthoracic group,and the difference was statistically significant(20.00%VS 4.55%,P<0.05).The satisfaction of patients in the transthoracic group was significantly higher than that in the traditional group,and the difference was statistically significant(72.73%VS 60.00%,P<0.05).Conclusions Compared with traditional thyroidectomy,transthoracic thyroidectomy has the advantages of short surgical time,less blood loss,quick recovery,beautiful incision and high patient satisfaction,which is worth promoting and applying.

关 键 词：甲状腺良性肿瘤 胸乳途径 腔镜甲状腺手术 患者满意度 

分 类 号：R736.1[医药卫生—肿瘤]