摘要
目的探讨腔镜甲状腺手术的安全性和微创性。方法2003年1月～2005年12月，行甲状腺（良性肿物）手术156例，其中腔镜甲状腺手术64例，传统开放甲状腺手术92例。比较两种术式的手术时间、术中失血量、切口大小、疼痛评分、切口美容评分、止痛药使用率、术后住院时间、住院费用、切口感染率和复发率。结果两组手术均获成功，无出血、声嘶、低血钙等并发症。开放组4例切口积液。腔镜组与开放组相比，失血量少（15±10 ml vs 20±15ml，t=-2、330，P=0．021），疼痛轻（VAS评分2．5±1．0 vs 5．0±1．6，t=-11．079，P=0．000），切口美容满意度高（VAS评分8．0±1．5 vs 2．0±1．2，t=27．696，P=0．000），止痛药使用少（10例vs28例，χ^2=4．493，P=0．034），但手术时间长（80±20min vs 70±30min，t=2．330，P=0．021），住院费用高（5352．7±978元vs 4738．5±672元，t=4．651，P=0．000）。随访2～30个月，平均13个月，复发5例，其中腔镜组2例，传统组3例。结论腔镜甲状腺手术与传统甲状腺手术相比，具有切口小、美容佳、创伤小、恢复快、安全等优点，是治疗良性甲状腺疾病的理想手术方法。
Objective To explore the safety and invasion of endoscopic thyroidectomy （ET）. Methods A total of 156 cases of benign thyroid diseases were surgically treated from January 2003 to December 2005, including 64 cases of endoscopic thyroidectomy （Endoscopic Group） and 92 cases of traditional thyroidectomy （Traditional Group）. The operation time, hemorrhage volume, length of incision, Visual Analogue Scale （VAS） scores for pain severity and cosmetic appearance, analgesic requirements, postoperative hospital stay, hospitalization costs, wound infection rate, and recurrent rate were compared between the two groups, respectively. Results The operation was successfully completed in both of groups. No hemorrhage, hoarseness, or hypocalcemia was encountered. Wound hydrops occurred in 4 cases in the Traditional Group. As compared with the Traditional Group, the Endoscopic Group had less blood loss （15 ± 10 ml vs 20 ± 15 ml;t = -2. 330,P =0. 021 ） , lower VAS pain scores （2.5 ± 1.0 vs 5.0 ± 1.6;t = - 11. 079,P = 0. 000） , higher VAS cosmetic scores （8.0 ± 1.5 vs 2.0 ± 1.2;t = 27. 696,P = 0. 000） , and less analgesic requirements （10 cases vs 28 cases ;χ^2 = 4. 493 ,P = 0. 034） , but longer operation time （80 ± 20 min vs 70 ± 30 min; t = 2. 330,P = 0. 021 ） and higher hospitalization costs （ 5 352.7 ± 978 yuan vs 4 738.5 ± 672 yuan; t = 4.651, P = 0. 000 ）. Follow-up observations for 2- 30 months （mean, 13 months） revealed recurrence in 2 cases in the Endoscopic Group and 3 cases in the Traditional Group. Conclusions As compared with traditional operation, endoscopic thyroidectomy has advantages of minimal invasion, early recovery, short hospitalization time, and high safety, being an ideal option for benign thyroid diseases.
出处
《中国微创外科杂志》
CSCD
2006年第8期586-587,共2页
Chinese Journal of Minimally Invasive Surgery
