腔镜辅助颈部小切口手术与传统甲状腺手术治疗甲状腺良性肿瘤疗效比较

Comparative study of endoscopic small neck incision surgery and conventional thyroid surgery forbenign thyroid tumor

目的比较腔镜辅助颈部小切口手术与传统甲状腺手术治疗甲状腺良性肿瘤的临床效果。方法选取甲状腺良性肿瘤患者90例，采用随机数字法分为对照组和观察组，每组45例。对照组采用传统开放性手术治疗，观察组采用腔镜辅助颈部小切口手术治疗，对两组患者进行为期1年的随访，比较两组患者的手术时间、切口大小、术中出血量、住院时间、并发症发生率、术后疼痛情况及对切口瘢痕的满意度。结果观察组患者的切口大小、术中出血量和住院时间分别为（2.31±0.45）cm、（11.22±2.87）ml和（3.18±0.36）d，显著低于对照组[（6.95±1.28）cm、（28.63±7.51）ml和（5.43±0.85）d]，但手术用时[（44.62±10.37）min]显著高于对照组[（38.56±8.59）min]，差异有统计学意义（P〈0.05）。观察组术后轻度疼痛患者占73.33%，显著高于对照组（51.11%），术后中度疼痛和重度疼痛的患者分别为22.22%和4.44%，显著低于对照组（31.11%和17.78%），差异有统计学意义（P〈0.05）。观察组患者喉返神经损伤、切口瘀血、吞咽障碍、低钙抽搐等并发症总发生率为8.89%，显著低于对照组（26.67%），差异有统计学意义（P〈0.05）。观察组患者对术后切口瘢痕的总体满意度为95.56%，显著高于对照组（73.33%），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肿瘤，具有切口小、出血量少、恢复快、疼痛轻、并发症少、瘢痕不明显等优点，疗效确切，安全性高，患者满意度高，值得推广应用。

Objective To compare the clinical effects of endoscopic small neck incision surgery and conventional thyroid surgery on thyroid benign tumors. Methods Ninty cases of benign thyroid tumor were randomly divided into control group and observation group, with 45 cases in each group. Thecontrol group was treated by the traditional open surgery, and the observation group was treated by video- assisted mini incision surgery, a period of 1 year of follow-up for the two groups, the operation time, inci- sion size, amount of bleeding, hospitalization time, complication rate, postoperative pain and satisfaction of scar was compared between the two groups. Results The incision size, bleeding volume and hospital- ization time was （2.31 ±0.45） cm, （11.22 ±2. 87） ml and （3.18 ±0. 36） d, which was significantly lower than those of the control group[ （6. 95 ± 1.28） cm, （28.63 ±7.51 ） ml and （5.43 ±0. 85 ） d but the operation time was （44. 62 ± 10. 37 ） min, which was significantly higher than that of the control group[ （38.56 ± 8.59 ） min ], there were significant differences （ P 〈 0. 05 ）. The patients with mild pain accounted for 73.33% in the observation group, which was significantly higher than that in the control group （51.11% ）, the postoperative moderate pain and severe pain were respectively accounted for 22.22% and 4.44%, which was significantly lower than those of the control group （31.11% and 17.78% ） , there were significant differences（P 〈0. 05 ）. The incidences of recurrent laryngeal nerve in- jury, incision blood stasis, dysphagia, convulsion and other complications was 8.89% in the observation group, which was significantly lower than that of the control group （ 26. 67% ）, there was significant difference （P 〈 0. 05 ）. The overall satisfaction degree of incisional scar after surgery was 95.56%, which was significantly higher than that in the control group （ 73.33% , P 〈 0.05 ）. Conclusions Video-assisted mini incision surgery for benign thyroid tumors has the advantages of small incision, less bleeding, faster recovery, less pain, fewer complications and not obvious scar, which has high safety and high patient satisfaction degree, so it is worthy of popularization and application.