腹腔镜改良胸乳晕径路与传统手术治疗良性甲状腺肿瘤的临床比较

Clinical comparison of laparoscopic modified breast areola approach and traditional surgery in the treatment of benign thyroid tumor

目的比较腹腔镜改良胸乳晕径路与传统手术治疗良性甲状腺肿瘤的临床疗效。方法选取2012年3月至2014年8月74例良性甲状腺肿瘤患者为研究对象，将患者随机分为观察组和对照组，每组37例，观察组采用腹腔镜改良胸乳晕径路手术，对照组采用传统手术，比较两组手术时间、术中出血量、术后引流量、切口长度、住院时间、疼痛指数以及并发症情况。结果观察组手术时间、术后引流量分别为（126.15±53.84）min、（75.26±30.45）ml，显著高于对照组[（89.36±42.45）min、（46.91±16.83）ml]（P〈0.05），观察组术中出血量、切口长度、术后7 d疼痛指数、并发症发生率分别为（18.69±8.11）ml、（2.37±1.01）cm、（2.15±1.09）分、10.8%，显著低于对照组[（37.72±12.48）ml、（7.59±1.86）cm、（2.92±1.32）分、29.7%]（P〈0.05）。结论腹腔镜改良胸乳晕径路手术治疗良性甲状腺肿瘤与传统手术比较，具有美容、疼痛轻、恢复快等优点，可以有效减少对患者的副损伤，降低并发症发生率，值得临床应用和推广。

Objective To compare the clinical efficacy of laparoscopic modified breast areola approach and traditional surgery on benign thyroid tumor.Methods Seventy-four patients with benign thyroid tumor from March 2012 to August 2014 were selected as the research objects, they were randomly divided into the observation group and the control group, with 37 cases in each group. The observation group received laparoscopic modified breast areola approach surgery, and the control group received traditional surgery. The operation time, intraoperative bleed loss, postoperative drainage volume, length of incision, hospitalization time, pain index and complications of the two groups were compared.Results The operation time, postoperative drainage volume in the observation group were （126.15±53.84）min, （75.26±30.45）ml respectively, which were significantly higher than those of the control group [（89.36±42.45）min, （46.91±16.83）ml] （P〈0.05）. The intraoperative blood loss, length of incision, postoperative 7 d pain index and complication rate in the observation group were （18.69±8.11）ml, （2.37±1.01）cm, （2.15±1.09）scores, 10.8% respectively, which were significantly lower than those of the control group [（37.72±12.48）ml, （7.59±1.86）cm, （2.92±1.32）scores, 29.7%]（P〈0.05）.ConclusionsCompared with traditional surgery, laparoscopic modified breast areola approach surgery in the treatment of benign thyroid tumor has advantages of cosmetology, light pain, fast recovery, can reduce the secondary injury effectively, and reduce the complication rate, so it is worthy of clinical application and promotion.