腔镜外科手术治疗甲状腺肿瘤的临床效果及安全性研究

Clinical Efficacy and Safety of Endoscopic Surgery for Thyroid Tumors

目的:探讨腔镜外科手术治疗甲状腺肿瘤的临床效果及安全性。方法:回顾性分析笔者所在医院2016年2月-2018年2月收治的301例甲状腺肿瘤患者的临床资料,依照手术方法的不同将其分为对照组(149例)和观察组(152例)。对照组行传统开放性手术,观察组行经胸乳入路腔镜下手术,比较两组临床效果。结果:观察组术中出血量、切口长度、术后住院时间均显著优于对照组(P<0.05)。观察组手术时长、引流管拔除时间均长于对照组,切口引流量多于对照组,差异均有统计学意义(P<0.05)。观察组美容满意度高于对照组,差异有统计学意义(P<0.05)。两组VAS评分随术后时间延长不断降低,且对照组在术后1、3、5 d的VAS评分均显著高于观察组,差异有统计学意义(P<0.05)。两组术后饮水呛咳及声音嘶哑发生率比较,差异无统计学意义(P>0.05),观察组术后切口感染、吞咽悬吊感、手足抽搐发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论:腔镜外科手术治疗甲状腺肿瘤的临床治疗效果显著,安全性好,美容效果明显,在条件成熟时基层医院同样也可开展。

Objective:To explore the clinical efficacy and safety of endoscopic surgery for thyroid tumors.Method:The clinical data of 301 patients with thyroid tumor admitted in our hospital from February 2016 to February 2018 were retrospectively analyzed.According to different surgical methods,they were divided into control group(149 cases) and observation group(152 cases).The control group underwent traditional open surgery,and the observation group underwent endoscopic surgery through thoracic and breast approach.The clinical effects of the two groups were compared.Result:The amount of bleeding during operation,length of incision,and postoperative hospital stay in the observation group were significantly better than those in the control group(P<0.05).The operation time,drainage tube removal time of the observation group were longer than those in the control group,and the incision drainage volume was higher than that in the control group,the differences were statistically significant(P<0.05).The cosmetic satisfaction of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The VAS scores of the two groups were continuously decreased with the prolongation of the postoperative time,and the VAS scores of the control group were significantly higher than those of the observation group on the 1 st,3 rd and 5 th postoperative days,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of drinking cough and hoarseness between the two groups(P>0.05).The incidence of incision infection,swallowing suspension,hand and foot convulsions in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Endoscopic surgery for thyroid tumor has obvious clinical treatment effect,good safety,and obvious cosmetic effect,which can also be carried out in primary hospitals when conditions are ripe.