改良经胸乳入路腔镜甲状腺切除术的临床效果及安全性研究

Clinical effect and safety of endoscopic thyroidectomy by modified transthoracic approach

目的探讨改良经胸乳入路腔镜甲状腺切除术的临床效果及安全性。方法80例甲状腺疾病患者,使用随机抽选的方式分为对照组和观察组,各40例。对照组使用传统开放甲状腺切除术治疗,观察组使用改良经胸乳入路腔镜甲状腺切除术治疗。比较两组并发症发生情况、术中出血量、住院时间、手术时间及术后疼痛评分。结果观察组的术中出血量(44.7±22.5)ml少于对照组的(78.2±47.8)ml,住院时间(13.6±6.1)d和手术时间(136.3±10.7)min均短于对照组的(16.7±6.5)d、(141.9±10.9)min,差异有统计学意义(P<0.05)。观察组的术后并发症发生率12.50%显著低于对照组的35.00%,差异有统计学意义(P<0.05)。观察组术后1 d、1周的疼痛评分分别为(3.91±0.87)、(2.27±0.39)分,均低于对照组的(4.43±1.25)、(3.73±0.58)分,差异有统计学意义(P<0.05)。结论在甲状腺疾病患者治疗中使用改良经胸乳入路腔镜甲状腺切除术,出血量少,安全性高,且术后并发症减少,给人体带来的损伤较小,疼痛和出血量得到了明显的控制,是一种安全可行的治疗方式,值得临床推广。

Objective To discuss the clinical effect and safety of endoscopic thyroidectomy by modified transthoracic approach.Methods A total of 80 patients with thyroid disease were randomly divided into control group and observation group,with 40 cases in each group.The control group was treated with conventional open thyroidectomy,and the observation group was treated with endoscopic thyroidectomy by modified transthoracic approach.The complications,intraoperative blood loss,hospitalization time,operation time and postoperative pain score were compared between the two groups.Results The intraoperative blood loss(44.7±22.5)ml in the observation group was less than(78.2±47.8)ml in the control group,and the hospitalization time(13.6±6.1)d and operation time(136.3±10.7)min were shorter than(16.7±6.5)d and(141.9±10.9)min in the control group.All the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 12.50%,which was significantly lower than 35.00%in the control group,and the difference was statistically significant(P<0.05).The pain scores of the observation group at 1 d and 1 week after surgery were(3.91±0.87)and(2.27±0.39)points,which were lower than(4.43±1.25)and(3.73±0.58)points of the control group,and the differences were statistically significant(P<0.05).Conclusion Endoscopic thyroidectomy by modified transthoracic approach in the treatment of patients with thyroid disease is a safe and feasible modality with less bleeding,high safety,and fewer postoperative complications,less damage to the body,and can significantly control the pain and bleeding,which is worthy of clinical promotion.