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腔镜与传统开放甲状腺切除术的比较 被引量:17

Comparison of endoscopic and open thyroidectomy
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摘要 目的探讨腔镜甲状腺切除术的优缺点。方法2003年12月-2004年8月,我院将甲状腺疾病61例随意分成2组,腔镜组30例,开放组3l例。分析比较腔镜组与开放组的手术时间、术中出血量,住院时间,术后疼痛评分,术后3个月颈部感觉情况、吞咽情况及美容效果评价。结果开放组手术时间比腔镜组明显缩短[(78±34)min vs.(126±53)min,t=4.125,P=0.000)]。腔镜组术中出血量(20±13)ml,明显少于开放组(34±19)ml(t=-3.313,P=0.002)。术后24、48h疼痛腔镜组比开放组轻(t=-3.255,P=0.002;t=-2.598,P==0.012)。术后3个月腔镜组1例发生颈部感觉减退,2例吞咽不适,开放组有11例颈部感觉减退或异常(r=10.894,P=0.001),9例吞咽不适(x^2=5.773,P=0.016)。腔镜组所有患者对术后美容效果均满意,开放组19例对术后美容效果不满意(x^2=52.141,P=0.000)。结论腔镜甲状腺切除术术中出血少、术后疼痛轻,有极佳的美容效果,是一种安全、有效的手术方法。 Objective To investigate advantages and disadvantages of endoscopic thyroidectomy. Methods A total of 61 consecutive patients with thyroid diseases from December 2003 to August 2004 in this hospital were freely divided into two groups: the Endoscopic Group (30 patients) and the Open Group (31 patients). The operating time, blood loss, hospital stay, postoperative pain assessment, jugular sensation 3 months after operation, swallowing function, and cosmetic outcomes between the two groups were compared. Results The operating time in the Open Group was significantly shorter than that in the Endoscopic Group (78 ± 34 min vs 126 ± 53 min; t = 4. 125, P = 0. 000). The intraoperative blood loss was less in the Endoscopic Group (20 ± 13 ml) than in the Open Group (34 ± 19 ml) (t = -3. 313, P =0. 002). The postoperative pain in the Endoscopic Group was slighter than that in the Open Group 24 and 48 hours after operation ( t = 3. 255, P = 0. 002 ; t = - 2. 598, P = 0.012 ). Three months after operation, jugular hypesthesia and discomfort at swallowing occurred in 1 and 2 patients in the Endoscopic Group, respectively, whereas jugular hypesthesia or paresthesia occurred in 11 patients (X^2= 10. 594, P = 0. 001 ) and discomfort at swallowing happened in 9 patients (X^2=5. 773,P=0. 016) in the Open Group. All patients in the Endoscopic Group were satisfied with the cosmetic results, but 19 patients in the Open Group complained of unsatisfactory cosmetic outcomes (X^2 = 52. 141, P = 0. 000). Conclusions Endoscopic thyroidectomy gives little blood loss, mild postoperative pain, and good cosmetic results, being a feasible and safe procedure.
出处 《中国微创外科杂志》 CSCD 2006年第2期119-120,共2页 Chinese Journal of Minimally Invasive Surgery
关键词 甲状腺疾病 甲状腺切除术 腔镜 Thyroid disease Thyroidectomy Endoscopy
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参考文献2

  • 1Huscher CS, Chiodini S, Napolitano C, et al. Endoscopic right thyroidlobectomy. Surg Endosc, 1997,11 (8) :877.
  • 2王存川,陈鋆,胡友主,吴东波,徐以浩.内镜甲状腺切除术150例[J].中华外科杂志,2004,42(11):675-677. 被引量:92

二级参考文献3

  • 1Miccoli P, Berti P, Raffaelli M, et al. Minimally invasive video-assisted thyroidectomy. Am J Surg, 2001,181:567-570.
  • 2Ohshima A, Simizu S, Okido M, et al. Endoscopic neck surgery: current status for thyroid and parathyroid diseases. Biomed Pharmacother, 2002, 56 Suppl 1:48-52.
  • 3Maeda S, Shimizu K, Minami S, et al. Video-assisted neck surgery for thyroid and parathyroid diseases. Biomed Pharmacother,2002,56:92-95.

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