腔镜技术在甲状腺疾病外科治疗中的运用

Application of endoscopic techniques in the surgical treatment of thyroid disease

目的分析研究腔镜技术在甲状腺疾病外科治疗中的运用。方法使用腔镜甲状腺切除术治疗甲状腺疾病,观察手术过程及术后患者的恢复情况,并对临床资料进行分析研究。结果腔镜甲状腺手术切口小且切口不易发觉,对患者的伤害小、出血少、恢复快。手术成功的患者有40例,占总人数的90.91%,其中中转开刀的患者有4例。患者手术时间为40～180 min,平均(90±5)min,平均出血量为5～100 mL。患者大多术后6 h可以下床进行活动,无头痛、恶心、呕吐,可进流质饮食,无皮下气肿,未用镇痛药。患者在进行颈部引流手术后第2天可将引流管拔除,患者术后3～4 d可以出院。4例患者术后胸前区皮肤出现小面积的淡黄色瘀斑,患者术后病理诊断为:甲状腺囊腺瘤26例,结节状甲状腺肿囊性变10例,甲状腺腺瘤8例。结论腔镜技术在甲状腺疾病外科手术中的运用,满足了广大患者对于身体健康的需求,特别是在美容效果上的需求。腔镜甲状腺手术的术后出血、颈部不适、疼痛等并发症和传统手术相比,优势较为明显,且美容效果显著。

Objective To analyze and research the application of endoscopic techniques in the surgical treatment of thyroid disease. Methods Endoscopic thyroidectomy was used to treat thyroid disease, the surgery process and the postoperative situation were observed, and the clinical data was carried out and analyzed. Results Endoscopic thyroid surgical incision was small and not easy to find, the harm to the patients was small, the bleeding was less, and the pa- tients could recover rapidly. The patients had taken lots of surgery, the success of them was 40 cases, accounting for 90.91% of the total number, of which transit surgery were 4 cases. The operative time in patients lasted for 40-180 min, the average time was （90-＋5） min, the average amount of bleeding was 5-100 mL. Patients after surgery mostly could get out of bed in 6 h, without headache, nausea, vomiting, and could easily get into the liquid diet, without sub- cutaneous emphysema, and without using the analgesics. Patients could remove the drainage tube at the second day af- ter the neck drainage surgery, patients could discharge at post-operative 3-4 d. The skin of the chest area in the 4 cases of patients showed pale yellow ecchymosis after finishing surgery, the postoperative pathological diagnosis were as follows： 26 cases of thyroid cystadenoma, 10 cases of nodular goiter cystic transformer, 8 cases of thyroid adenoma. Conclusion The application of the endoscopic techniques in the surgical surgery of thyroid disease meets the need of the vast patients for the body health, especially for the beauty results. The complications such as postoperative bleed- ing, neck discomfort, pain of endoscopic thyroid surgery are better than traditional surgery, the advantages are obvious, and the beauty results are quite good.