经乳晕入路腔镜甲状腺手术治疗甲状腺良性疾病的效果及安全性

Clinical effect and safety of endoscopic thymidectomy via areola approach in treating thyroid benign diseases

目的研究经乳晕入路腔镜下甲状腺手术治疗甲状腺良性疾病的效果及安全性。方法将2014年6月~2016年6月我院普外科收治的62例甲状腺良性疾病患者按随机数字表法分为观察组和对照组各31例,对照组患者行开放性甲状腺手术,观察组患者行经乳晕入路腔镜下甲状腺手术。比较两组患者临床病理生理参数、术后VAS疼痛、NSS美容满意度评分及术后并发症发生情况。结果观察组患者手术时间[(70.5±11.8)min]、术中出血量[(41.2±16.5)ml]、术后引流时间[(1.5±0.4)d]、术后引流量[(71.8±10.9)ml]及住院时间[(5.1±0.6)d]均显著低于对照组的(94.9±10.3)min、(73.6±11.8)ml、(2.8±0.9)d、(103.9±11.5)ml及(8.3±1.7)d(t=8.6735,8.8930,7.2699,11.2797,9.7506;P<0.01)。术后6、12、24 h观察组患者VAS疼痛评分分别为(4.13±0.95)、(3.27±0.71)、(5.29±0.88)分,均显著低于对照组的(5.28±0.73)、(4.61±0.85)、(3.73±0.94)分(t=5.3443,6.7365,4.9294;P<0.01);术后1、3个月观察组患者切口瘢痕NSS满意度评分分别为(8.37±1.15)、(7.21±1.39)分,均显著高于对照组的(4.16±1.03)、(3.85±1.70)分(t=15.1832,8.5193;P<0.01);观察组患者术后并发症发生率为6.5%,对照组为16.1%,差异无统计学意义(χ2=0.5193,P>0.05)。结论经乳晕入路腔镜甲状腺手术治疗甲状腺良性疾病创伤小、恢复快、术后疼痛轻、效果满意、美容效果好。

Objective To observe the clinical effect and safety of endoscopic thymidectomy via areola approach in treat- ing thyroid benign diseases.Methods A total of 62 patients with thyroid benign diseases who were treated in our hospital from June 2014 to June 2016 were enrolled and divided into observation group and control group by random number table,with 31 patients in each group.Patients in the observation group were treated with endoscopic thymidectomy via areola approach,while patients in the control group were treated with open surgery.The clinical pathophysiological pa- rameters,VAS pain score,NSS cosmetic satisfaction and complication rate of two groups were recorded and compared. Results Operation time[（70.5±11.8） min],intraoperative blood loss [（41.2±16.5） mll,postoperative drainage time [（1.5± 0.4） all,postoperative drainage[（71.8±10.9） roll and hospital stay time [（5.1±0.6） d] in the observation group was signifi- cantly less than （94.9±10.3） min,（73.6±1 1.8） ml,（2.8±0.9） d,（103.9±11.5） ml and （8.3±1.7） d in the control group （t= 8.6735,8.8930,7.2699,11.2797,9.7506;P〈0.01）.VAS score of 6,12,24 h after surgery in the observation group [（4.13± 0.95）,（3.27±0.71）,（5.29±0.88）scores] was significantly lower than （5.28±0.73）,（4.61±0.85）,（3.73±0.94） scores in the con- trol group （t =5.3443,6.7365,4.9294;P〈0.0!）,while NSS score of 1,3 months after surgery in the observation group [（8.37±1.15）,（7.21±1.39） scores] was significantly higher than （4.16±1.03）,（3.85±1.70） scores in the control group （t= 15.1832,8.5193;P〈0.01）.Postoperative complication rate of the observation group was 6.5%,which had no significant dif- ference than 16.1% of the control group （X2=0.5193,P〉0.05）.Conclusion Endoscopic thymideetomy via areola approach has the advantages of less trauma,sooner recover,less pain and better beauty effect in surgical treatment of thyroid be- nign diseases.