五步法腔镜下保留舌骨的甲状舌管囊肿切除术的临床应用研究

Study on the Clinical Application of Five-step Endoscopic Thyroglossal Cyst Resection with Hyoid Bone Preservation

目的:探究及分析五步法腔镜下保留舌骨的甲状舌管囊肿切除术的临床效果。方法:将2020年1月-2022年6月牡丹江市肿瘤医院的80例甲状舌管囊肿患者根据随机数字表法分为对照组40例和观察组40例。对照组进行传统经颈部切口甲状舌管囊肿切除术治疗,观察组则进行五步法腔镜下保留舌骨的甲状舌管囊肿切除术治疗。比较两组术中出血量、经口进食时间、术后引流量、美观程度(温哥华瘢痕评定量表)、手术前后的疼痛程度[视觉模拟评分法(VAS)评分]、吞咽功能状态[吞咽功能评估表(GUSS)]及嗓音状态[嗓音障碍指数(VHI)]。结果:观察组的术中出血量及术后引流量均显著少于对照组,经口进食时间显著早于对照组,术后3个月,观察组温哥华瘢痕评定量表评分显著低于对照组,差异均有统计学意义(P<0.05),术前两组VAS评分、GUSS评分构成及VHI比较,差异均无统计学意义(P>0.05),术后1、2周观察组的VAS评分及VHI均显著低于对照组,GUSS评分构成均显著优于对照组,差异均有统计学意义(P<0.05)。结论:五步法腔镜下保留舌骨的甲状舌管囊肿切除术的临床效果较好,且对吞咽功能及嗓音等不良影响较小。

Objective:To investigate the clinical effect of five-step endoscopic thyroglossal cyst resection with hyoid bone preservation.Method:A total of 80 patients with thyroglossalcyst in Mudanjiang Tumor Hospital from January 2020 to June 2022 were divided into the control group 40 cases and the observation group 40 cases by the random number table method.The control group was treated with traditional thyroglossalcyst resection by neck incision,the observation group was treated with five-step endoscopic thyroglossal cyst resection with hyoid bone preservation.Then the intraoperative blood loss,oral feeding time,postoperative drainage volume,aesthetic degree(Vancouver scar assessment scale),pain degree[visual analogue scale(VAS)score],swallowing function state[gugging swallowing screen(GUSS)]and voice status[voice handicap index(VHI)]before and after operation were compared between the two groups.Result:The intraoperative blood loss and postoperative drainage volume of observation group were significantly less than those of control group,the oral feeding time was significantly earlier than that of control group,the Vancouver scar assessment scale of the observation group were significantly lower than those of the control group at three months after the operation,the differences were statistically significant(P<0.05),the VAS score,GUSS score composition and VHI of two groups before operation were not statistically significant(P>0.05),the VAS score and VHI index of observation group at first and second week after operation were significantly lower than those of the control group,the GUSS scores compositions at first and second week after operation were significantly better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The clinical effect of five-step endoscopic thyroglossal cyst resection with hyoid bone preservation is better,and its influences for swallowing function and voice are smaller.