腔镜辅助颈部小切口手术与传统手术治疗单侧甲状腺良性疾病的对比研究

Comparison of endoscopic-assisted thyroidectomy and traditional thyroidectomy in the treatment of oneside benign thyroid nodules

目的探讨腔镜辅助颈部小切口手术治疗甲状腺良性疾病的临床效果。方法回顾性分析2013年1—12月65例手术治疗单侧甲状腺良性疾病患者的病历资料，其中腔镜辅助颈部小切口甲状腺手术（腔镜组）33例和传统手术（对照组）32例，比较两组手术时间、术中出血量、术后引流量、术后VAS疼痛评分、手术并发症发生率、美容效果满意度、住院费用等。结果两组患者手术均获成功。腔镜组术中出血量显著少于对照组[（26．7±23．1）m1与（45．2±28．9）ml，t=2．85，P〈0．05]；术后引流量腔镜组明显低于对照组[（31．4±8．1）ml与（83．6±17．3）ml，t=15．66，P〈0．05]；腔镜组术后第1、第3天的VAS疼痛评分均低于对照组[（1．5±0．4）分与（1．0±0．2）分、（2．2±0．5）分与（1．5±0．3）分，t值分别为6．01、7．29，P均〈0．05]。腔镜组的患者美容效果满意度（97．0％）高于对照组（68．8％）（x2=9．02，P〈0．05）。结论腔镜辅助颈部小切口手术治疗甲状腺良性疾病安全可行，体现了腔镜手术微创及美容的优点，具有较高的临床应用价值。

Objective To explore the feasibility and efficacy of endoscopic-assisted thyroidectomy （EAT） in the treatment of benign thyroid nodules. Methods Sixty-five patients with one-side benign thyroid nodules were treated with EAT （EAT group, n = 33 ） or conventional open thyroidectomy（ control group, n = 32） from Jan. To Dec. 2013. The operation time, blood loss amount, volume of drainage, visual analog scores （VAS） for pain severity, occurrence of postoperative complications, evaluation of cosmetic, and hospital expense were recorded. Results The operation were performed successfully in patients of two groups. Blood loss volume was significantly less in EAT group （ 26. 7 ± 23. 1 ） ml than in control group （ （45.2± 28.9 ） ml, t = 2. 85, P 〈 0.05 ）. The volume of drainage in EAT group was （ 31.4 ±8.1 ） ml, less than that in control group （ （ 83.6 ±17.3 ） ml, t = 15.66,P 〈 0. 05 ）. The VAS at the day of 1 st, 3rd after operation were （ 1.5 ±0. 4） and （ 1.0± 0. 2） in EAT group was significantly lower than those in eontrol group （ （ 2. 2 ± 0.5 ） and （ 1.5 ±0. 3 ） ; t = 6. 01,7. 29 ;P 〈0. 05 ）. Satisfaction rate of cosmetic in EAT group was higher than control group （97. 0% vs 68. 8%, X2 = 9. 02,P 〈 0.05 ）. Conclusion EAT is proved with safe and feasible in the treatment of benign thyroid nodules,which is with the advantage of minimally invasive and cosmetic results.