摘要
目的 评价开放性小切口直接入路甲状腺切除术的应用价值。方法 回顾性分析1999年1月~2003年6月,采用小切口直接入路甲状腺切除术治疗的210例(A组)甲状腺结节的临床资料,并与1995年1月~1998年12月,采用传统手术方法治疗的218例(B组)甲状腺结节治疗情况进行比较。结果A组与B组手术切口长度、手术时间、失血量(估算)和住院时间比较分别为:(3.7±0.4)cm和(5.2±0.5)cm,(45.9±10.4)min和(74.4±17.7)min,(46.0±13.1)ml和(75.8±17.3)ml,(3.5±0.6)d和(6.0±0.7)d,两组之间差异有统计学意义(P〈0.05)。324.例(A组172例,B组152例)随访2~8年,复发率分别为3.49%(6/172)和4.61%(7/152),两组之间差异元统计学意义(P〉0.05)。但A组切口平整,疤痕短小,颈部切口周围皮肤感觉元明显异常。结论 小切口直接入路法是治疗原发性甲状腺良性结节创伤最小的开放性术式,简单安全,疗效可靠。
Objective To evaluate the clinical value of direct mini - incision thyroidectomy. Methods The clinical data of 210 patients who underwent direct mini - incision thyroidectomy for various types of thyroid nodules from January 1999 to June 2003 (group A) were natrospectively compared with those of 218 patients who underwent conventional thyroidectomy from January 1995 to December 1998 (group B). Results The length of the skin incision,operatlve time,blood loss and hospital stay between group A and group B were (3.7 ± 0.4) cm and (5.2 ± 0.5) cm, (45.9 ± 10.4) min and (74.4 ± 17.7) min, (46.0 ±13.1) ml and (75.8± 17.3) ml, (3.5 ± 0.6) days and (6.0± 0.7) days, respectively. There were significant difference between group A and group B (P 〈 0.05).Three hundred and twenty- four patients (172 cases in group A ancl 152 cases in group B) were survived for the mean 3.5 years. There was no significant difference in the recurrence rate between group A (3.49%) and group B (4.61%) (P〉0.05). Compared with group B, the skin incision was shorter, mere smooth, and less hypesthesia or paresthesia than that in group A. Conclusion Direct mini- incision thyroidactomy is a minimal invasive procedure for various benign thyroid nodules,which is simple, safety and effective.