超声刀经胸乳入路腔镜下行甲状腺癌根治术48例临床分析

Clinical Analysis in 48 Cases of Adopting the Video-assisted Endoscopic Thyroidectomy via Breast Approach

目的:探讨超声刀经胸乳入路腔镜下行甲状腺癌根治术的临床疗效以及手术安全性情况,为临床提供可靠的治疗方案。方法:选择2015年1月至2016年1月在湖北省钟祥市人民医院手术治疗的48例甲状腺癌患者,按照随机原则平均分为两组,其中对照组依旧实施传统开放手术,观察组给予腹腔镜下超声刀经胸乳入路行甲状腺癌根治术治疗,观察两组患者术中及术后相关指标、术后VAS疼痛评分、术后并发症发生率。结果:观察组患者的手术时间、引流时间及住院时间均短于对照组,出血量也较少,差异显著(P<0.05);观察组患者VAS疼痛评分在术后第1天、第2天、第3天也均比对照组程度轻,差异显著(P<0.05);两组患者的术后并发症有声音嘶哑、暂时性低钙、手足麻木、发音困难等,其中对照组发生率为33.33%(8/24),而观察组为8.33%(2/24),差异有统计学意义(P<0.05)。结论:甲状腺癌根治术患者采用超声刀经胸乳入路腔镜相比于传统的开放手术在手术环节方面优势出众,不仅缩短手术时间,在术后也减轻了疼痛程度,降低了并发症的发生率。

Objective： To study the clinical effect and safety of video-assisted endoscopic thyroidectomy via breast approach and provide the reliable therapy. Method： 48 patients with thyroid cancer treated from January 2015 to January 2016 in our hospital were selected. The subjects were randomly and equally divided into two groups. The control group adopted the open operation; the observation group adopted the video-assisted endoscopic thyroidectomy via breast approach. The clinical index during and after surgery, VAS point and incidence rate of complications were evaluated. Result： The operation time, drainage time and overall hospitalization time for observation group was shorter than control group; during surgery, the bleeding volume for observation group was fewer than control group （P〈0.05）; after ld, 2d and 3d of surgery, the VAS point for observation group was fewer than control group （P〈0.05）; the major complications included hoarseness, temporary deficient calcium, deadlimb, dysphonia, etc. The incidence rate of complications for control group （33.33%, 8/24） was higher than that of observation group （8.33%, 2/24） （P〈0.05）. Conclusion： For patients with thyroid cancer, the video-assisted endoscopic thyroidectomy via breast approach has a better effect than open operation, can shorten the operation time, reduce the pain degree and incidence rate of complications.