多种手术入路治疗甲状腺肿瘤

Clinical analysis of the treatment of thyroid tumor with a variety of surgical approaches

目的 比较三种手术入路治疗甲状腺肿的效果. 方法 对巨野县人民医院2011年7月至2014年7月收治的186例甲状腺肿瘤患者展开研究,平均分为三组. A组行腔镜手术,B组为外侧入路,C组为改良中间入路,比较三组手术时间、引流量、住院时间、并发症发生率、美容满意度及复发率. 结果 三组手术时间及引流量两两比较差异均未见统计学意义（P〉0.05）;C组住院时间最短,与A、B两组比较差异有统计学意义（P〈0.05）. C组并发症发生率为1.6%（1例皮下气肿）,显著低于A、B两组的11.3%和12.9%（P〈0.05）;仅1例患者复发,复发率显著低于A、B两组（ P〈0.05 ）;A、B组美容满意度均较高,分别达到96.8%、93.5%,显著高于C组（ P〈0.05）. 结论 改良中间入路甲状腺切除术治疗甲状腺肿瘤是一种安全、有效、并发症少的术式,患者术后恢复更快,具有较高临床借鉴价值.

Objective To compare the effects of three surgical approaches on patients with thyroid tumor .Meth-ods One hundred and eighty-six patients with thyroid tumor were treated from July 2011 to July 2014 as the research ob-jects, and they were divided into three groups .Group A was given the endoscopic surgery , group B was given the lateral approach, and group C was given the modified into intermediate approach .And then the operative time, drainage, hospital stay, complication rates , the satisfaction of beauty and recurrence rate of the three groups were compared .Results The surgical time and drainage of three groups had no significant difference （ P〉0.05 ）; group C had the shortest length of stay, compared with group A and group B , there was significant difference （P〈0.05）.The complication rates of group C was 1.6%（ 1 case of subcutaneous emphysema ） , which was significantly lower than that of the group A and group B （11.3%,12.9%） , P〈0.05; and there was only one patient relapsed , and the recurrence rate was significantly lower than that of group A and group B （ P〈0.05 ）; group A and group B had a high beauty satisfaction degree （ 96.8% and 93.5%）, which were significantly higher than that of group C （P〈0.05）.Conclusions Thyroidectomy with the modified into intermediate approach in treating thyroid cancer is a surgical approach which is safe , effective, and has less surgical complications , patients can get quick recoveries , and it is worthy of promotion and application .