乳晕入路腔镜甲状腺切除术对甲状腺癌患者术后嗓音及吞咽功能的影响分析  

To Analysis of the Effect of Endoscopic Thyroidectomy Via Areola Approach on Postoperative Voice and Swallowing Function in Patients with Thyroid Carcinoma

作　　者：张文娟 魏勇军 ZHANG Wenjuan;WEI Yongjun(Department of Otorhinolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian,361021,China)

机构地区：[1]厦门医学院附属第二医院耳鼻咽喉头颈外科,福建厦门361021

出　　处：《中外医疗》2024年第35期18-21,共4页China & Foreign Medical Treatment

摘　　要：目的探讨乳晕入路腔镜甲状腺切除术(endoscopic thyroidectomy via areola approach,ETCAA)对甲状腺癌(thyroid carcinoma,TC)患者术后嗓音及吞咽功能的影响。方法方便选取2022年10月—2023年10月厦门医学院附属第二医院收治的84例TC患者作为研究对象,根据不同手术方式分为两组,各42例。对照组采用开放甲状腺切除术(open thyroidectomy,OT)治疗,观察组采用ETCAA治疗。比较两组患者术中及术后指标、嗓音功能、吞咽功能、生活质量、美容满意度及并发症发生情况。结果观察组手术时间长于对照组,术后嗓音障碍指数量表(Voice Handicap Index,VHI)评分、标准吞咽功能评分量表(Standardized Swallowing Assess‐ment,SSA)评分低于对照组,癌症患者生存质量评定表(European Organization for Research and Treatment of Cancer,EORTC QLQ-C30)评分高于对照组,差异均有统计学意义(P均<0.05)。观察组美容满意度为90.48%(38/42),高于对照组的71.43%(30/42),并发症总发生率为7.14%(3/42),低于对照组的23.81%(10/42),差异均有统计学意义(χ^(2)=4.941,4.459;P=0.026,0.035)。两组淋巴结清扫数目、术中出血量及住院时间比较,差异均无统计学意义(P均>0.05)。结论ETCAA与OT治疗TC效果相当,但ETCAA可减轻手术对患者嗓音及吞咽功能的影响,患者美容满意度高且并发症少。Objective To investigate the effect of endoscopic thyroidectomy via areola approach(ETCAA)on postoperative voice and swallowing function in patients with thyroid carcinoma(TC).Methods A total of 84 patients with TC admitted to the Second Affiliated Hospital of Xiamen Medical College from October 2022 to October 2023 were conveniently selected as the research objects.According to different surgical methods,they were divided into two groups,with 42 cases in each group.The control group was treated with open thyroidectomy(OT),and the observation group was treated with ETCAA.The intraoperative and postoperative indexes,voice function,swallowing function,quality of life,cosmetic satisfaction and complications were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,the postoperative Voice Handicap Index(VHI)score and Standardized Swallowing Assessment(SSA)score of the observation group were lower than those of the control group,the European Organization for Research and Treatment of Cancer(EORTC QLQ-C30)score of the observation group was higher than that of the control group,and the differences were statistically significant(all P<0.05).The cosmetic satisfaction of the observation group was 90.48%(38/42),which was higher than 71.43%(30/42)of the control group,the total incidence of complications was 7.14%(3/42),which was lower than 23.81%(10/42)of the control group.The differences were statistically significant(χ^(2)=4.941,4.459;P=0.026,0.035).There was no significant difference in the number of lymph node dissection,intraoperative blood loss and hospitalization time between the two groups(all P>0.05).Conclusion ETCAA is equivalent to OT in the treatment of TC,but ETCAA can reduce the impact of surgery on patients'voice and swallowing function,with high cosmetic satisfaction and fewer complications.

关 键 词：甲状腺癌 乳晕入路腔镜甲状腺切除术 开放甲状腺切除术 嗓音功能 吞咽功能 并发症 

分 类 号：R736.1[医药卫生—肿瘤]