经乳晕切口全腔镜下甲状腺良性肿瘤切除手术的临床应用研究

Clinical application of endoscopic benign thyroidectomy through areola incision

目的:探讨经乳晕切口全腔镜下甲状腺良性肿瘤切除手术的临床应用价值。方法:选择2019年1月—2019年12月择期行手术治疗的甲状腺良性肿瘤患者68例,按照随机数字表法分为观察组与对照组,每组34例。对照组采用传统的开放性甲状腺切除术治疗,观察组采用经乳晕切口的全腔镜手术治疗。比较两组患者手术情况和术后一般情况、术后不同时间疼痛评分(VAS)与美容效果评分(NSS)以及术后并发症发生率。结果:观察组平均手术时间长于对照组,术中出血量、术后引流量均少于对照组,术后住院时间短于对照组,两组比较,差异均具有统计学意义(P<0.05);观察组术后1 d,2 d,3 d VAS评分均低于对照组,术后3个月及6个月NSS评分均高于对照组,差异均具有统计学意义(P<0.05);观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论:经乳晕切口全腔镜下甲状腺肿瘤切除手术创伤小,术中出血少,术后恢复快,患者痛苦小,并发症少,美容效果更佳,可作为治疗甲状腺良性肿瘤的优选术式。

Objective:To investigate the clinical value of endoscopic thyroidectomy through areola incision.Methods:All 68 patients with benign thyroid tumor who were scheduled for surgery in hospital from January 2019 to December 2019 were included in this study.They were randomly divided into observation group and control group,34 cases in each group.The control group was treated with traditional open thyroidectomy,and the observation group was treated with endoscopic surgery through areola incision.The general situation,visual analogue scale(VAS)and cosmetic effect score(NSS)at different time after operation,and postoperative complications were compared between the two groups.Results:The average operation time of the observation group was longer than that of the control group,the average intraoperative blood loss and postoperative drainage were lower than those of the control group,and the average postoperative hospital stay was shorter than that of the control group,with significant difference between the two groups(P<0.05).The VAS scores of the observation group were lower than those of the control group at 1 d,2 d and 3 d after operation,and the NSS scores of the observation group were higher than those of the control group at 3 and 6 months after operation,with significant difference between the two groups(P<0.05).The total incidence of postoperative com-plications in the observation group was lower than that in the control group,and the difference was significant(P<0.05).Conclusion:Endoscopic thyroidectomy through areola incision has the advantages of less trauma,less bleeding,shorter recovery time,less pain,fewer complications and better cosmetic effect,which can be used as the preferred operation for the treatment of benign thyroid tumors.