摘要
目的比较完全腔镜与常规开放甲状腺切除术之间的差别,探讨腔镜下甲状腺手术的可行性和实用性。方法对2008年7月～2009年12月在邵阳市第二人民医院因"甲状腺单发结节"接受手术治疗的52例患者,按照患者的意愿非随机地分为完全腔镜组(23例)和常规开放组(29例),对两组患者的手术时间、术中出血量、严重并发症、术后疼痛、住院时间、住院费用和术后近期疗效进行比较。结果 (1)术中情况:所有患者均接受甲状腺腺叶次全切除或部分切除,完全腔镜组1例中转开放。完全腔镜组的手术时间短于常规开放组(t=-11.895,P=0.000)完全腔镜组术中出血量少于常规开放组(t=-14.396,P=0.001)。(2)术后情况,腔镜组的术后疼痛程度小于开放组(x2=7.891,P=0.019)完全腔镜组的住院时间短于常规开放组(t=8.083,P=0.000),完全腔镜组的住院费用高于常规开放组(t=2.855,P=0.006)。(3)术后近期疗效,术后3个月完全腔镜组吞咽时不适感以及美容效果均明显优于常规开放组。术后6个月B超检查均无复发。结论完全腔镜甲状腺切除术安全可行,具有创伤小、恢复快、住院时间短等诸多明显的优点,但住院费用仍较传统方法偏高。
Objective To compare the differences between total endoscopic and conventional open thyroidectomy,as well as explore the feasibility and efficacy of endoscopic surgery.Methods From July 2008 to December 2009,tolally 52 patients with single thyroid nodule underwent thyroidectomy in our hospital.According to the patients＇ choice,we divided them into two groups：total endoscopy（23cases）,and conventional open（29cases）groups.The perioperative data including operation time,intraoperative blood loss,serious complications,postoperative pain,hospital stay,hospital expense,and slort-term outcomes,were compared between the two groups.Results Total or subtotal thyroidectomy was performed in all of the patients;one patient in the total endoscopic group was converted to open surgery during the operation.The operation time in total endoscopic group was significantly shorter than conventional open group（t=-11.895,P=0.000）.whereas the intraoperative blood loss in the conventional open group was significantly more than total endoscopic group（t=-14.396,P=0.001）.After the operation,patients in the total endoscopic showed less surgery-related pain than conventional open group（x2=7.891,P=0.019）.The patients in the total endoscopic group stayed in the hospital shorter than conventional open group（t=8.083,P=0.000）.Total endoscopic group had higher hospital expense than conventional open group（t=2.855,P=0.006）.We re-examined all the patients in three months after the surgery,finding that total endoscopic group showed better results in the symptom of swallowing discomfort and cosmetic outcome than conventional open group.B-ultrasonography was carried out in six months on the patients,showing no recurrence.Conclusion Total endoscopic thyroidectomy is feasible and safe,it superior in minimal invasion,quick recovery,and short hospital stay ;however its cost is higher than traditional method.
出处
《当代医学》
2010年第36期112-114,共3页
Contemporary Medicine
关键词
腔镜手术
甲状腺切除术
对比研究
Endoscopic surgery
Thyroidectomy
Comparative study
