摘要
目的探讨腔镜手术治疗原发性甲状腺功能亢进的安全性及有效性。方法回顾性分析2003年1月至2007年1月腔镜手术治疗30例甲状腺功能亢进患者的临床资料，并与同期45例开放手术的甲状腺功能亢进患者进行对比研究。结果所有手术均获成功，腔镜组无中转开放手术。腔镜组及开放组手术时间分别为（110．5±12．3）min与（98．8±15．5）min（t=3．46，P〈0．05）：术中出血量分别为（45．5±11．5）ml与（65．8±12．6）ml（t=7．07，P〈0．05）；住院总费用分别为（11128．5±358．8）元与（6500．9±231．9）元（t=67．92，P〈0．05）；引流总量分别为（125．9±10．7）ml与（46．5±9．4）ml（t=33．90，P〈0．05）；引流时间分别为（2．98±0．5）d与（1．75±0．3）d（t=13．31，P〈0．05）；止痛药使用率分别为20．0％（6／30）与42．2％（19／45）（x^2=4．00，P〈0．05）；一过性声音嘶哑发生率分别为6．6％（2／30）与8．8％（4／45）（x^2=0．12，P〉0．05）。所有患者均获随访18～61个月，平均47．8个月。腔镜组出现甲状腺功能低下1例，1例甲状腺功能亢进复发；开放组出现甲状腺功能低下1例，2例甲状腺功能亢进复发，两组差异无统计学意义（x^2=0．08，P〉0．05）。结论腔镜双侧甲状腺次全切除术治疗原发性甲状腺功能亢进是安全有效的，且具有颈部美容效果。
Objective To study the safety and efficacy of laparoscopic subtotal thyroidectomy for primary hyperthyroidism. Methods From January 2003 to January 2007, seventy-five patients with primary hyperthyroisism underwent subtotal thyroidectomy, among which thirty patients by laparoscopic procedure and forty-five patients by open surgery. The clinical data were retrospectively analyzed. Results All the surgery were successful. No patient in the endoscopic group was converted to open surgery. The mean operative times of endoscopic group and open surgery group were （110. 5 ± 12, 3） min vs （98. 8 ±15. 5） min （ t = 3.46, P〈0.05）, the mean blood loss were （45.5 ±11.5） ml vs （65.8 ±12.6） ml （t =7.07, P〈 0.05）, the inhospital fee were （11128.5 ±358.8） RMB yuan vs （6500.9 ±231.9） RMB yuan （t = 67.92, P〈0. 05） , the amount of drainage were （125.9 ±10.7） ml vs （46.5 ±9.4） ml （t=33.90, P〈 0.05）, the days of drainage were （2.98±0.5） dvs （1.75±0.3） d （t=13.31, P〈0.05）, the use of analgetieswas in 20. 0% （6/30） vs 42. 2% （19/45） （X^2 =4.00, P 〈0.05）, the rate of temporary hoarseness was 6. 6% （2/30） vs 8.8% （4/45） （ X^2 = 0. 12, P 〉 0. 05 ）. There were 1 hypothyroidism and 1 recurrent hyperthyroidism in endoscopic group while 1 hypothyroidism and 2 recurrent hyperthyroidism in open surgery group after a 47.8 month＇s follow-up. Conclusions Endoscopic subtotal thyroideetomy for hyperthyroidism patients is safe, effective and presents a significant cosmetic advantage.
出处
《中华普通外科杂志》
CSCD
北大核心
2009年第12期973-976,共4页
Chinese Journal of General Surgery
