腔镜辅助颈部小切口手术与传统开放手术治疗甲状腺良性肿瘤的临床对比分析

Clinical Comparison of Endoscopic-assisted Mini-incision Thyroidectomy and Traditional Thyroidectomy in the Treatment of Thyroid Tumor

目的探讨腔镜辅助颈部小切口手术治疗甲状腺良性肿瘤的可能性与安全性。方法将湖北省黄石第一医院自2010年1月至2011年6月收治的47例甲状腺良性肿瘤患者根据治疗适应证和家属意见分为两组,治疗组(30例)患者行腔镜辅助颈部小切口手术,对照组(17例)患者行传统开放手术。观察、比较两组患者的临床疗效及术后并发症的情况。结果治疗组手术时间显著多于对照组;治疗组术中出血量、术后住院时间显著少于对照组(P<0.05);术后随访1年,两组复发率比较差异无统计学意义(P>0.05)。治疗组患者术后均对切口瘢痕满意,对照组有7例患者对切口瘢痕不满意,两组比较差异有统计学意义(P<0.05);治疗组术后并发症发生率显著低于对照组(10.0%vs 35.29%)(P<0.05)。结论腔镜辅助颈部小切口手术治疗甲状腺良性肿瘤效果肯定,在美容效果上有明显优势,值得在临床上推广应用。

Objective To study the possibility and safety of endoscopic-assisted mini-incision thyroidec-tomy. Methods According to the treatment indications and families advices,47 cases admitted to the First Hospital of Huangshi of Hubei Province from January 2010 to June 2011 were divided into treating group and control group. 30 cases of treating group were treated with endoscopic-assisted mini-incision thyroidectomy, 17 cases of control group with traditional thyroidectomy. The clinical efficacy and postoperative complications of the two groups was observed and compared. Results The operating time of operation in the treating group was significantly longer than that in the control group（ P 〈0.05 ）. The volume of hemorrhage during operation was less than that in the control group（ P 〈0.05 ）. The length of postoperative hospital stay were shorter than that in the control group（ P 〈0.05 ）. The recurrent rate during the one year follow-up of the two groups had no difference（ P 〉0.05 ）. All patients of the treating group were satisfied with the cosmetic results, but 7 patients in the control group complained of unsatisfactory cosmetic （ P 〈 0.05 ） ; postoperative complication incidence was significantly lower than the control group （ 10.0% vs 35.29%, P 〈 0.05 ）. Conclusion Endoscopic-assisted mini-incision thyroidectomy is a safe and effective method with fine cosmetic result, and it is worthy of popularization and application in clinical.