经胸乳入路腔镜术与传统开放术治疗甲状腺腺瘤的效果对比

Effect comparation of endoscopic thyroidectomy via chest-breast approach and traditional open surgery in the treatment of thyroid adenoma

目的探讨经胸乳入路腔镜治疗甲状腺腺瘤的临床效果。方法选取2011年1月~2014年12月本院收治的200例甲状腺腺瘤患者作为研究对象,随机分为观察组和对照组,各100例。观察组采用经胸乳入路腔镜手术,对照组给予开放手术。比较两组的手术时间、术中出血、术后住院时间、术后疼痛评分、术后6 h血气分析结果及出院时的声音嘶哑、饮水呛咳、低钙性抽搐发生率。结果观察组的手术时间显著长于对照组,术中出血显著少于对照组,术后住院时间显著短于对照组,术后疼痛VAS评分显著低于对照组,差异有统计学意义（P〈0.05）。观察组的PCO2水平显著低于对照组,PO2水平显著高于对照组,差异有统计学意义（P〈0.05）。观察组术后的声音嘶哑、饮水呛咳以及低钙性抽搐发生率显著低于对照组,差异有统计学意义（P〈0.05）。结论经胸乳入路腔镜下甲状腺腺瘤切除术的手术出血量少,且不影响血气分析结果,术后并发症少,值得临床推广应用。

Objective To explore the clinical effect of endoscopic thyroidectomy via chest-breast approach in the treatment of thyroid adenoma. Methods 200 cases with thyroid adenoma from January 2011 to December 2014 in our hospital were selected and randomly divided into the observation group and the control group,100 cases in each group.The observation group was given endoscopic thyroidectomy via chest-breast approach,the control group was given open surgery method.The operative time,blood loss,postoperative hospital stay,postoperative pain score,6 hours after blood gas analysis and the incidence rate of hoarse voice,choking water,low calcium convulsion in two groups was compared. Results The operative time in the observation group was longer than that in the control group,blood loss in the observation group was less than that in the control group,postoperative hospital stay in the observation group was shorter than that in the control group,postoperative pain VAS score in the observation group was lower than that in the control group,with significant difference（P〈0.05）.The level of PCO2 in the observation group was lower than that in the control group,the level of PO2 in the observation group was higher than that in the control group,with significant difference（P〈0.05）.The incidence rate of hoarse voice,choking water,low calcium convulsion in the observation group was lower than that in the control group,with significant difference（P〈0.05）. Conclusion Thyroid adenoma lobectomy with endoscopic thyroidectomy via chest-breast approach has less blood loss,which does not affect blood gas analysis results and has fewer complication,it is worthy of clinical promotion and application.