不同手术方法对甲状腺良性肿瘤患者治疗效果的比较

Comparison of the therapeutic effects of different surgical methods on patients with benign thyroid tumor

目的比较不同手术方法对甲状腺良性肿瘤患者治疗效果的差异。方法选取2015年1月至2017年12月于广西医科大学第一附属医院就诊且需手术治疗的120例甲状腺良性肿瘤患者为研究对象,将采用腋窝入路常规腔镜甲状腺切除术的40例患者纳入A组,将采用无充气腋窝入路单孔腔镜甲状腺切除术的40例患者纳入B组,将采用常规甲状腺切除术的40例患者纳入C组。观察并比较三组患者的手术相关指标(术中出血量、手术时间、切口引流量)、术后相关指标[视觉模拟评分法(visual analogue scale,VAS)评分、患者满意度评分、住院费用、术后住院天数]和术后并发症发生情况。结果A组和B组患者术中出血量均显著少于C组(均P<0.05),VAS评分均显著低于C组(均P<0.05),患者满意度评分均显著高于C组(均P<0.05),术后住院天数均显著短于C组(均P<0.05),但A组和B组患者术中出血量、VAS评分、患者满意度评分和术后住院天数比较差异均无统计学意义(均P>0.05)。三组患者手术时间、切口引流量、住院费用和术后并发症发生率比较差异均无统计学意义(均P>0.05)。结论对于甲状腺良性肿瘤患者,无充气腋窝入路单孔腔镜甲状腺切除术和腋窝入路常规腔镜甲状腺切除术的治疗效果均优于常规甲状腺切除术,患者术后康复快,满意度高,亦可根据患者具体情况选择最佳术式。

Objective To compare the therapeutic effects of different surgical methods on patients with benign thyroid tumor.Method A total of 120 patients with benign thyroid tumors who needed surgical treatment in the First Affiliated Hospital of Guangxi Medical University from January 2015 to December 2017 were selected as subjects,40 patients with routine endoscopic thyroidectomy via axillary approach were included in group A,40 patients who underwent endoscopic thyroidectomy using the gasless unilateral axillary approach were included in group B,40 patients who underwent routine thyroidectomy were included in group C.The operationrelated indexes(intraoperative blood loss,operation time,incision drainage),postoperative related indexes[visual analogue scale(VAS)score,patient satisfaction score,hospitalization cost,postoperative hospital day]and postoperative complications among the three groups were observed and compared.Result The intraoperative blood loss in group A and group B were significantly less than that in group C(all P<0.05),the VAS scores were significantly lower than that in group C(all P<0.05),the patient satisfaction scores were significantly higher than that in group C(all P<0.05),and the postoperative hospital days were significantly shorter than that in group C(all P<0.05),however,there were no significant differences in intraoperative blood loss,VAS score,patient satisfaction score and postoperative hospital day between group A and group B(all P>0.05).There were no significant differences in operation time,incision drainage,hospitalization cost and incidence of postoperative complications among the three groups(all P>0.05).Conclusion For patients with benign thyroid tumor,the therapeutic effects of endoscopic thyroidectomy using the gasless unilateral axillary approach and routine endoscopic thyroidectomy via axillary approach are better than those of routine thyroidectomy,patients can recover quickly and have high satisfaction after operation,the best operation can also be chosen according to the specific conditions of the patients.