腔镜辅助颈部小切口手术在甲状腺良性肿瘤中的应用

Value of endoscopic assisted neck incision in the treatment of benign thyroid tumor

目的 探讨腔镜辅助颈部小切口手术对甲状腺良性肿瘤患者近远期预后的影响。 方法 选取84例确诊为甲状腺良性肿瘤患者为研究对象，根据随机数字表法将患者分为观察组与对照组，每组42例。对照组行传统开放手术治疗，观察组行腔镜辅助颈部小切口手术治疗，对比分析两组患者近远期治疗效果及安全性。 结果 观察组术后住院时间、手术切口长度、术中失血量少于对照组，术后疼痛评分低于对照组（P〈0.05），而手术时间长于对照组（P〈0.05）。观察组术后并发症发生率为9.52%，对照组为33.33%，差异有统计学意义（P〈0.05）。观察组术后1年复发率为9.52%，对切口瘢痕满意率为95.24%，对照组分别为35.71%、71.43%，两组差异有统计学意义（P〈0.05）。 结论 腔镜辅助颈部小切口手术治疗甲状腺良性病变具有切口小、术中出血量少、术后并发症发生率低、微创、美容等优点。

Objective To investigate the application value and effect of short and long term prognosis of endoscopic assisted small incision in the treatment of benign thyroid tumor. Methods Eighty-four cases of benign thyroid tumor patients were divided into observation group （n = 42） and control group （ n = 42） according to the random number table. The control group was implemen- ted with conventional open surgery and the observation group was implemented with laparoscopic surgery assisted small incision in the neck. The short and long term efficacy and safety of treatment of two groups were compared. Results The postoperative hospital stay of observation group was shorter than that of the control group, the incision length, intraoperative blood loss were less than those of the control group, postoperative pain score was lower than that of the control group （ P 〈 0. 05 ）, while the operating time was longer than that of the control group （ P 〈 0. 05 ）. The postoperative complication rate of observation group（9.52% ） was lower than that of the control group（33.33% ）, the difference was significant （P 〈 0. 05 ）. The recurrence rate and scar satisfartion rate were 9.52% and 95.24% in the obseruation group, and 35.71% , 71.43 % respectively in the control group after one year of treatment. And the differences were significant （P 〈 0.05）. Conclusions Endoscopic small neck incision for the treatment of thyroid benign lesions has the advantages of small incision, small amount of bleeding, low incidence of postoper- ative complications, minimally invasive, cosmetic and other advantages.