老年甲状腺肿瘤患者腔镜与开放甲状腺肿瘤摘除术的对照研究

Comparative study of endoscopic and open thyroid tumor removal in the elderly patients with thyroid tumor

目的比较老年甲状腺肿瘤患者腔镜与开放甲状腺肿瘤摘除术的临床疗效及安全性。方法选取2013年2月-2015年5月来我院就诊的老年甲状腺肿瘤患者98例，按照随机数字表法分为研究组和对照组．各49例。对照组采用传统开放甲状腺肿瘤摘除术，研究组采用经乳晕腔镜甲状腺手术。比较两组患者的手术时间、住院时间、术后引流量、失血量、切口美容评分、临床疗效、术后并发症情况。结果研究组手术时间、住院时间较对照组短，失血量、术后引流量较对照组少，切口美容评分较对照组高，差异有统计学意义（P〈0．05）。研究组临床治疗总有效率（91．84％）较对照组（71．42％）高，差异有统计学意义（P〈0．05）。研究组并发症发生率与对照组比较差异无统计学意义（P〉0．05）。结论老年甲状腺肿瘤患者采用腔镜甲状腺肿瘤摘除术治疗效果更好，不仅能缩短手术时间、住院时间，降低失血量及术后引流量，而且美观性更高，有较高的临床应用价值。

Objective To compare the clinical efficacy and safety of endoscopic and open thyroid tumor removal in the elderly patients with thyroid tumor. Methods A total of 98 elderly patients with thyroid tumors who were admitted to our hospital from February 2013 to May 2015 were divided into two groups according to the method of random number table, with 49 patients in the study group and the control group each. The control group was given traditional open thyroid tumor removal, and the study group was given the endoscopic thyroid surgery via mammary areola. The operation time, length of stay, postoperative drainage volume, volume of blood loss, incision cosmetic score, clinical curative effect and postoperative complications were compared between the two groups. Results Compared with the control group, the operation time and length of stay in the study group were shorter, and the volume of blood loss and the postoperative drainage were less than those in the control group. The incision cosmetic score was higher than that in the control group. The differences were statistically significant（P〈0.05）. The total effective rate（91.84%） was higher in the study group than that in the control group （71.42%）, and the difference was statistically significant （P〈0.05）. The incidence of complications in the study group was not significantly different compared with the control group （P〉0.05）. Conclusion Endoscopic thyroid tumor removal in the elderly patients with thyroid tumor is more effective, which is not only able to shorten the operation time, length of stay, reduce blood loss and postoperative drainage, but also has a higher aesthetic value and clinical application value.