两种腹腔镜手术方案治疗甲状腺良性肿瘤的对比分析

Clinical comparison of two kinds of laparoscopic surgical procedures in the treatment of benign thyroid tumors

目的:探讨2D与3D腹腔镜手术对甲状腺良性肿瘤患者围手术期临床指标及安全性的影响。方法:选取2016年3月至2018年3月收治的138例甲状腺良性肿瘤患者,以随机数字表法分为2D组(n=69)与3D组(n=69),分别经胸乳入路行2D、3D腹腔镜手术;比较两组患者围手术期临床指标、术后VAS评分、外观满意度及术后并发症发生率。结果:3D组患者手术时间、术中出血量均少于2D组(P<0.05);两组患者术后引流量、总住院时间及住院费用差异无统计学意义(P>0.05);术后第1天、第3天,3D组VAS评分均低于2D组(P<0.05);两组患者术后外观满意度、并发症发生率差异无统计学意义(P>0.05)。结论:相较2D腹腔镜,3D腹腔镜手术用于经胸乳入路甲状腺良性肿瘤切除术能有效降低操作难度,减少医源性创伤,并有助于缓解术后疼痛。

Objective:To compare the influence of 2 D-and 3 D-laparoscopic surgical procedures for patients with benign thyroid tumors on perioperative clinical indexes and safety.Methods:From Mar.2016 to Mar.2018,138 patients with benign thyroid tumors were randomly divided into control and observation group in accordance with the random number table,with 69 cases in each group.The control group received 2 D-laparoscopic operation and the observation group received 3 D-laparoscopic operation via chest-breast approach.The perioperative clinical indicators,postoperative VAS score,appearance self-satisfaction and postoperative complication rate of both groups were collected and compared.Results:The operation time was shorter,the intra-operative blood loss was less,and the pain VAS score on 1 d and 3 d postoperatively were lower in observation group than those in control group(P<0.05).No significant differences were found in the postoperative drainage amount,total hospitalization time,treatment cost,appearance self-satisfaction and postoperative complication rate between the two groups(P<0.05).Conclusions:Compared with 2 D-laparoscopic procedure,the 3 D-laparoscopic procedure via chest-breast approach has more advantages in reducing the operation difficulty,decreasing iatrogenic trauma degree and relieving postoperative pain during the treatment of benign thyroid tumors.