经口入路腔镜下甲状腺癌根治术的临床疗效及预后分析

Clinical effect and prognosis of endoscopic thyroidectomy for thyroid cancer via oral approach

目的探讨经口入路腔镜下甲状腺癌根治术的临床疗效及预后。方法回顾性分析2016年1月至2017年12月150例甲状腺癌患者资料,根据术式不同分为采取开放手术治疗的传统组及采取经口入路腔镜下甲状腺癌根治术的经口组各75例。数据均采用SPSS22.0统计软件进行处理,术中术后各项指标、术后疼痛评分、生活质量评分采用( x±s)表示,独立t检验,并发症发生率采用χ2检验,P<0.05表示差异有统计学意义。结果经口组手术时间、住院时间、术中出血量、术后引流量、术后疼痛评分、术后并发症发生率均低于传统组(P<0.05);淋巴结清扫数量大于传统组(P<0.05)。两组出院时生活质量评分差异无统计学意义(P>0.05),术后6个月、术后12个月均较出院时明显提高(P<0.05),组间比较经口组均高于传统组(P<0.05);随访1年,经口组复发率、颈部淋巴结转移率、远处转移率均低于对照组,差异有统计学意义(P<0.05)。结论经口入路腔镜下甲状腺癌根治术治疗甲状腺癌取得的临床效果更佳,且患者预后更为理想,可作为优选治疗方案。

Objective To investigate the clinical efficacy and prognosis of radical thyroidectomy via oral endoscopic surgery.Methods A retrospective analysis of 150 patients with thyroid cancer from January 2016 to December 2017 was divided into the traditional group with open surgery and the oral group with radical endoscopic radical thyroidectomy,75 cases each.The data were processed by SPSS 22.0 statistical software.All indexes,postoperative pain scores and quality of life scores were expressed by( x±s),and compared with independent t test,and complication rate was detected byχ2 test,P<0.05 meant the difference was statistically significant.Results The operation time,hospitalization time,intraoperative blood loss,postoperative drainage volume,postoperative pain score,and postoperative complication rate were lower in the oral group than in the traditional group(P<0.05).The number of lymph node dissection was more than that in the traditional group(P<0.05).There was no significant difference in the quality of life scores between the two groups(P>0.05).The postoperative 6 months and 12 months after surgery were significantly higher than those at the time of discharge the traditional group(P<0.05);the follow-up period of 1 year,the oral recurrence rate,cervical lymph node metastasis rate,distant metastasis rate were lower than the control group,the difference was statistically significant(P<0.05).Conclusion Oral endoscopic radical thyroidectomy for thyroid cancer has a better clinical outcome,and the prognosis is more ideal.It can be used as the preferred treatment.