经口底入路腔镜与开放甲状腺切除术治疗良性甲状腺结节性疾病的临床研究

The clinical research of transoral and open thyroidectomy for innocent thyroid nodule disease

目的探讨经口底入路腔镜甲状腺切除术与传统开放甲状腺切除术治疗良性甲状腺病变的临床效果。方法选取2013年11月~2015年8月我院收治的甲状腺腺瘤或结节性甲状腺肿患者62例,按照患者意愿分为观察组和对照组。观察组25例采用经口底入路腔镜手术治疗;对照组37例采用传统开放甲状腺切除治疗。比较两组手术时间、术中出血量、术后引流量、住院时间、术后并发症发生率及美观满意度。结果观察组甲状腺切除术均成功完成,围术期无明显并发症,观察组术中出血为(25±5)ml,术后住院时间为(4.4±0.6)d;对照组术中出血量为(35±5)ml,术后住院时间为(6.6±0.7)d,差异有统计学意义(P<0.05)。两组在手术时间、术后第一天引流量、术后复发情况、术后6个月咽部吞咽不适感比较,差异无统计学意义(P>0.05)。结论与传统开放甲状腺切除术比较,经口底入路甲状腺切除术具有切口隐蔽、术后恢复快的优点,同样安全且可靠。

Objective To investigate the clinical effect of transoral and conventional open thyroidectomy to treat benign thyroid disease.Methods 62 patients with benign thyroid disease in our hospital from November 2013 to August 2015 were selected and were divided into the observation group and the control group by the patients willing.The observation group was included 25 patients and were received thrnsoral access for thyroidectomy,the control group was included 37 patients and had conventional open thyroidectomy.The operation time,postoperative drainage,hospital stay time,postoperative complications and cosmetic satisfactory were compared.Results 25 patients were successfully completed transoral thyroidectomy,without any perioperative complications.The intraoperative blood loss of observation group was（25±5） ml and hospitalization time was（4.4±0.6） days;the intraoperative blood loss of control group was（35±5） ml and hospitalization time was（6.6±0.7） days,with siginifiant difference（P〈0.05）,the operation time,the first day drainage after operation,the rate of postoperative recurrence and the feeling about pharyngeal swallowing after 6 months were no siginifiant differences（P〈0.05）.Conclusion Transoral thyroidectomy can be perfomed in patients with begnign thyroid lesions with cosmetic incision,recoveryfaster,safe and reliable compared to convential open thyroidectomy.