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腔镜与开放性甲状腺手术的对比研究 被引量:42

Endoscopic thyroidectomy by breast approach versus conventional open thyroidectomy:a prospective study
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摘要 目的腔镜与开放性甲状腺手术临床效果的对比研究。方法回顾性分析2002年8月至2005年5月113例腔镜甲状腺切除术(腔镜组)和104例开放性甲状腺切除术(开放组)的临床资料。结果两组的手术时间、住院时间、术后住院时间差异无显著性意义。腔镜组失血量(42.5±62.8)mL明显少于开放组(118.2±120.8)mL,差异有显著性意义(P<0.05);而腔镜组引流量多于开放组(P<0.05);腔镜组术后恢复活动时间为(2.2±1.0)d,与开放组(2.5±1.1)d比较差异无显著性意义(P>0.05);腔镜组术后镇痛药需求比开放组明显减少,而住院费用高于开放组。术后并发症腔镜组以喉上和喉返神经损伤为主,且甲状腺功能亢进术后并发症发生率较高,而开放组主要是术后出血。结论选择合适的病例实施腔镜甲状腺手术是安全可行的,具有美容、疼痛轻、出血少的优点。 Objective To compare the clinical effect of endoscopic thyroidectomy by breast approach with conventional open thyroidectomy prospectively. Methods The clinical data of 113 patients underwent endoscopic thyroidectomy (group endoscopy) and 104 patients underwent conventional open thyroidectomy (group open) performed between August 2002 and May 2005 was analyzed retrospectively. Results There was no significantly difference in operative time, time of stay and postoperative stay between two groups. Blood loss was significantly less in group endoscopy than that in group open [ (42.5 ±62. 8)mL vs ( 118. 2 ± 120. 8)mL] ( P 〈0. 05) ,but the volume of drainage in group endoscopy was increaser than that in group open [ ( 84. 9 ± 76. 1 ) mL vs (44.1 ± 38.7 ) mL ] ( P 〈 0. 05 ). Time taken to return to normal activity was (2. 2 ± 1.0) d in group endoscopy and ( 2. 5 ± 1.1 ) d in group open ( P 〉 0.05 ). The analgesic requirements was more decreased in group endoscopy than that in group open, but its cost of hospitalization in group endoscopy was higher than that in group open. The most postoperative complication was hum of superior or recurrent laryngeal nerve paralysis. Moreover there were more complications in hyperthyroid patients in group endoscopy than that in group open. Hemorrhage was the most postoperative complication in group open. Conclusion If suitable cases are selected, endoscopic thyroidectomy for thyroid diseases is feasible and safe with excellent cosmetic benefits, less blood loss and less pain compared with conventional surgery.
出处 《中国实用外科杂志》 CSCD 北大核心 2007年第3期229-231,共3页 Chinese Journal of Practical Surgery
关键词 甲状腺腔镜手术 甲状腺疾病 甲状腺开放性手术 endoscopic thyroidectomy thyroid disease open thyroidectomy
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