口腔前庭入路腔镜甲状腺手术治疗甲状腺良性肿瘤的效果

Effect of oral vestibular approach laparoscopic thyroid surgery in the treatment of benign thyroid tumors

目的探讨口腔前庭入路腔镜甲状腺手术治疗甲状腺良性肿瘤的效果及安全性。方法选择2020年7月至2021年5月广西壮族自治区桂平市人民医院明确诊断为甲状腺良性肿瘤、且有腔镜下甲状腺手术指征的120例患者为研究对象,依据随机数字表法分为观察组和对照组,每组60例。观察组实施经口腔前庭入路腔镜甲状腺手术,对照组实施经胸前入路腔镜甲状腺手术。比较两组手术时间、手术出血量、伤口总引流量、术后疼痛时间、并发症发生率、患者对切口的满意度、术后颈部活动舒适度以及社会适应能力。结果观察组手术时间、术后疼痛时间短于对照组,手术出血量、伤口总引流量少于对照组,并发症发生率低于对照组(P<0.05)。观察组对切口的满意度高于对照组(P<0.05)。观察组术后枕头不适、辅助工具不适应、疼痛不适、体温高以及其他颈部不适发生率低于对照组(P<0.05)。术前,两组社会适应能力评分比较,差异无统计学意义(P>0.05);术后,两组社会适应能力评分高于术前,且观察组高于对照组(P<0.05)。结论相比于经胸前入路腔镜甲状腺手术,经口腔前庭入路腔镜甲状腺手术治疗甲状腺良性肿瘤可获得更好的围手术期指标,患者术后颈部活动舒适度较高,对切口满意度较高,且患者术后社会适应能力更强。

Objective To investigate the efficacy and safety of oral vestibular approach endoscopic thyroid surgery in the treatment of benign thyroid tumors.Methods From July 2020 to May 2021,120 cases diagnosed as benign thyroid tumors and indicated for endoscopic thyroid surgery in Guiping People’s Hospital,Guangxi Zhuang Autonomous Region were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 60 cases in each group.The observation group received oral vestibular approach laparoscopic thyroid surgery,and control group received transfrontal approach laparoscopic thyroid surgery.The operation time,surgical blood loss,total wound discharge,postoperative pain time,complication rate,patients’incision satisfaction,postoperative neck movement comfort,and social adaptability were compared between two groups.Results The operation time and postoperative pain time in observation group were shorter than those in control group,the surgical blood loss and total wound discharge were less than those in control group,and the complication rate was lower than that in control group(P<0.05).The incision satisfaction in observation group was higher than that in control group(P<0.05).The incidence of postoperative pillow discomfort,maladjustment of auxiliary tools,pain and discomfort,high temperature,and other neck discomfort in observation group were lower than those in control group(P<0.05).Before surgery,there was no significant difference in social adaptability scores between two groups(P>0.05);after surgery,the social adaptability scores in both groups were higher than those before surgery,and observation group was higher than control group(P<0.05).Conclusion Compared with transfrontal approach laparoscopic thyroid surgery,oral vestibular approach laparoscopic thyroid surgery for benign thyroid tumors can achieve better perioperative indicators,with higher postoperative neck activity comfort,higher incision satisfaction,and stronger postoperative social adaptability.