腔镜甲状腺切除术治疗良性甲状腺疾病患者的可行性及安全性

Feasibility and safety of endoscopic thyroidectomy treating patients with benign thyroid disease

目的探讨腔镜甲状腺切除术治疗良性甲状腺疾病患者的可行性及安全性。方法选择2015年10月~2018年8月我院收治的51例良性甲状腺疾病患者作为研究对象,采用奇偶数法随机分为腔镜组(26例)和开放组(25例)。腔镜组行腔镜甲状腺切除术,开放组行传统开放式甲状腺切除术。比较两组手术指标、术后疼痛和瘢痕美容、炎性指标和术后不良事件发生情况。结果腔镜组术中失血量及术后引流量均少于开放组,手术时间和住院天数均短于开放组,差异有统计学意义(P<0.05);两组术后24h血清C反应蛋白(CRP)及皮质醇水平均高于术前,且腔镜组术后视觉模拟量表(VAS)评分和血清CRP及皮质醇等炎性指标均低于开放组,数字评分系统(NSS)评分高于开放组,差异有统计学意义(P<0.05),而组内不同时间VAS及NSS评分比较,差异无统计学意义(P>0.05);腔镜组不良事件总发生率(11.54%)低于开放组(44.00%),差异有统计学意义(P<0.05)。结论腔镜甲状腺切除术治疗良性甲状腺疾病可行性较高,手术用时短、恢复快、疼痛轻,能有效改善瘢痕美容满意度和炎性反应,且手术安全性较高。

Objective To investigate the feasibility and safety of endoscopic thyroidectomy treating patients with benign thyroid disease.Methods Altogether 51 patients with benign thyroid diseases in our hospital from October 2015 to August 2018 were selected as subjects and randomly divided into laparoscopic group(n=26) and open group (n=25) by the odd-even method.Laparoscopic group underwent endoscopic thyroidectomy and open group underwent conventional open thyroidectomy.The surgical indexes,postoperative pain and scar cosmetic,inflammatory indicators and postoperative adverse events of two groups were compared.Results In the laparoscopic group,the blood loss and postoperative drainage were less than that in the open group,the surgery time and hospitalization was shorter than that in the open group with statistical difference(P<0.05).Serum C-reactive protein(CRP) and cortisol levels 24 hours after operation in the two groups were higher than those before surgery,and visual analogue score (VAS) score and inflammatory markers such as CRP and cortisol in endoscopy group were lower than those in the open group,the numerical scoring system (NSS) score was higher than those in the open group with statistical differences (P<0.05).There were no significant differences in VAS and NSS scores between the two groups at different time points (P>0.05).The total incidence of adverse events of laparoscopic group (11.54%) was lower than that in the open group (44.00%) with statistical difference (P<0.05).Conclusion Endoscopic thyroidectomy is a more feasible treatment for benign thyroid disease.It has short operation time,quick recovery and light pain features,and can effectively improve the cosmetic satisfaction of scar and inflammatory response,and the operation safety is high.