无充气腋窝入路腔镜甲状腺手术在早期甲状腺肿瘤中的应用效果  

Application effect of gasless endoscopic thyroidectomy via axillary approach in early thyroid tumor

作　　者：何岩 周腼 时通 张琪 朱小朝 HE Yan;ZHOU Mian;SHI Tong;ZHANG Qi;ZHU Xiao-chao(Department of Thyroid and Breast Surgery,Suqian First Hospital,Suqian Jiangsu 223800,China)

机构地区：[1]宿迁市第一人民医院普外甲乳科,江苏宿迁223800

出　　处：《局解手术学杂志》2025年第4期329-332,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：宿迁市第一人民医院科研专项项目(SY202208);2021年度徐州医科大学附属医院发展基金(XYFZ2021008)。

摘　　要：目的探究无充气腋窝入路腔镜甲状腺手术对早期甲状腺肿瘤患者颈部功能、美学效果的影响。方法选取2020年12月至2023年12月我院收治的116例早期甲状腺肿瘤患者进行前瞻性研究,按区组随机法分为观察组和对照组,每组58例。对照组患者实施开放性甲状腺肿瘤切除术治疗,观察组患者实施无充气腋窝入路腔镜甲状腺手术治疗。比较2组患者手术指标、颈部功能、美容效果及并发症情况。结果与对照组比较,观察组患者手术时间更长(P<0.05),术中出血量、术后引流量更少(P<0.05)。2组患者颈部损伤指数的时点、组间、交互效应及吞咽障碍指数的时点、组间效应比较,差异均具有统计学意义(P<0.05);与术后3 d相比,2组患者术后6个月、术后12个月的颈部损伤指数、吞咽障碍指数均降低(P<0.05),且观察组患者术后6个月、术后12个月的颈部损伤指数、吞咽障碍指数均低于对照组(P<0.05)。与对照组相比,观察组患者美容效果更好(P<0.05)。观察组患者并发症总发生率低于对照组(P<0.05)。结论无充气腋窝入路腔镜甲状腺手术治疗早期甲状腺肿瘤具有较好疗效,可有效提高颈部功能与美学效果,促进患者恢复,且安全性及患者满意度较高。Objective To explore the effects of gasless endoscopic thyroidectomy via axillary approach on neck function and aesthetic effect in patients with early thyroid tumor.Methods A prospective study was conducted on 116 patients with early thyroid tumor admitted to our hospital from December 2020 to December 2023.They were divided into the observation group and the control group according to block random method,with 58 cases in each group.Patients in the control group underwent open thyroidectomy,while patients in the observation group underwent gasless endoscopic thyroidectomy via axillary approach.The surgical indicators,neck function,cosmetic effect,and complications of patients in the two groups were compared.Results Compared with the control group,the observation group had a longer surgical time(P<0.05),less intraoperative bleeding and postoperative drainage volume(P<0.05).There were statistically significant differences in terms of the time point,inter-group and interaction effects of the neck injury index and the time point and inter-group effects of swallowing disorder index of patients between the two groups(P<0.05).Compared with 3 days after surgery,the neck injury index and swallowing disorder index at 6 months and 12 months after surgery of patients in both groups decreased(P<0.05),and the neck injury index and swallowing disorder index at 6 months and 12 months after surgery of patients in the observation group were lower than those in the control group(P<0.05).Compared with the control group,the observation group had better cosmetic effects(P<0.05).The total incidence of complications of patients in the observation group was lower than that in the control group(P<0.05).Conclusion Gasless endoscopic thyroidectomy via axillary approach has better efficacy for early thyroid tumor,which can effectively improve neck function and aesthetic effect,promote the recovery of patients,and has high safety and patient satisfaction.

关 键 词：甲状腺肿瘤 早期 无充气腋窝入路腔镜甲状腺手术 免疫功能 颈部功能 美学效果 

分 类 号：R581[医药卫生—内分泌]