腔镜手术对早期分化型甲状腺肿瘤患者的临床疗效

Clinical efficacy of endoscopic surgery for patients with early differentiated thyroid tumor

目的探讨腔镜手术对早期分化型甲状腺肿瘤患者的临床疗效。方法选择2015年2月至2017年2月间本院收治的早期分化型甲状癌患者94例作为研究对象,按照手术方式的不同分为观察组42例(行全腔镜甲状腺切除术)和对照组52例(行开放式甲状腺切除术)。比较两组患者的手术相关指标、术后并发症情况及术后12周的美容效果满意度。结果两组患者均顺利完成手术,观察组无中转开放手术者。观察组患者的手术时间、术后首日引流量显著多于对照组,但观察组的创口长度、出血量、术后24 h VAS评分及住院时间均明显少于对照组(P<0.05);观察组术后短期并发症总发生率为4.76%,明显低于对照组的30.77%,观察组术后12周时美容效果满意率为90.48%,明显高于对照组的63.46%,差异均有统计学意义(P<0.05)。结论腔镜手术治疗早期分化型甲状腺肿瘤患者安全有效,术后近期并发症较少,术中出血量较少,且美容效果方面优于传统手术,易于患者接受,值得临床推广。

Objective To investigate the clinical efficacy of laparoscopic surgery for early differentiated thyroid tumors.Methods Ninety-four cases of early differentiated thyroid cancer treated in our hospital from February2015to February2017were selected as study subjects.According to the different surgical methods,42patients were divided into observation group(all cases undergoing thyroidectomy)and controls.Group of52patients(open thyroidectomy).The surgically-related indicators,short-term post-operative complications,and cosmetic outcome assessment at12weeks after surgery were compared between the two groups.Results Both groups of patients successfully completed the surgery.The observation group had no transfer to open surgery.The operative time of patients in the observation group and drainage volume were significantly higher on the following day than in the control group.However,the incision length,intraoperative blood loss,postoperative pain score,and length of stay in the observation group were significantly less than those in the control group(P<0.05).The total incidence of postoperative short-term complications in the observation group was4.76%,which was significantly lower than that in the control group(30.77%).The satisfaction rate of the cosmetic results of the observation group at12weeks after surgery was90.48%,which was significantly higher than that of the control group(63.46%).The differences were statistically significant(P<0.05).Conclusion Laparoscopic surgery is safe and effective in the treatment of early differentiated thyroid tumors.It has fewer postoperative complications,less intraoperative blood loss,and better cosmetic results than traditional surgery.It is easy for patients to accept.It is worthy of clinical promotion.