老年患者腔镜与开放甲状腺肿瘤摘除术的对照研究

Comparative study between endoscopic and open resection of thyroid neoplasm for aged patients

目的:对比分析为老年患者施行腔镜与开放甲状腺肿瘤手术的临床疗效及应用价值。方法:将112例老年甲状腺肿瘤患者随机分为治疗组和对照组,每组56例,治疗组行腔镜微创切除术,对照组行传统开放手术。对比分析两组手术时间、术中失血量、术后引流量、住院时间、住院期间费用、手术疗效、切口美容评分、并发症发生率等。结果:治疗组手术时间、住院时间明显短于对照组(P<0.05),术中出血量及术后引流量显著少于对照组(P<0.05)。住院期间费用显著高于对照组(t=6.392,P<0.05)。术后治疗组总有效率显著高于对照组(χ2=21.37,P<0.01),治疗组切口小,其切口美容评分显著优于对照组(t=32.565,P<0.05)。两组并发症发生率差异无统计学意义(χ2=0.00,P>0.05)。结论:腔镜微创甲状腺肿瘤摘除术较传统开放手术切口小、出血少、切口美容效果好、术后康复快、治愈率高、复发率低,可作为治疗老年甲状腺肿瘤患者的优先选择。

Objective： To comparatively investigate the clinical efficacy and application value between endoscopic and open surgery in treating thyroid neoplasm for aged patients. Methods：From Oct.2007 to Dec.2010,112 aged patients diagnosed as thyroid neoplasm were randomly divided into two groups as therapy group and control group equally.The therapy group underwent endoscopic thyroidectomy,while the control group underwent open operation.The 2 groups were compared in operative time,intraoperative blood loss,postoperative drainage volume,hospital stay,hospitalization cost,operative efficacy,cosmetic result and complication incidence. Results：The therapy group showed absolute advantages compared with control group in operative time（P〈0.05）,blood loss,postoperative drainage volume（P〈0.05）,hospital stay（P〈0.05）,total efficacy of surgery（χ2=21.37,P〈0.01） and cosmetic result（t=32.565,P〈0.05）.The hospitalization cost was higher in therapy group than that in control group（t=6.392,P〈0.05）.There was not significant difference between the two groups in incidence of complications（χ2=0.00,P〈0.05）. Conclusions：Endoscopic mini-invasive resection of thyroid neoplasm shows obvious advantages compared with traditional open resection,such as smaller incision,less blood loss,better cosmetic result,faster recovery and better efficacy.In a word,this prodecure could be recognized as the prior choice in treating thyroid tumor for aged patients.