摘要
目的探讨改良胸前切口入路腔镜甲状腺手术的临床效果。方法回顾分析2012年12月至2014年6月对甲状腺肿块在2~5 cm的患者行腔镜手术42例（腔镜组）、开放手术120例（开放组）。应用SPSS 17.0软件包进行统计学分析。手术时间、术后引流量、引流天数、总体引流量等计量资料用±s表示,采用t检验;术后颈部舒适度等采用χ~2检验,P〈0.05有统计学差异。结果腔镜成功手术41例,1例转为开放手术。腔镜组与对照组比较：手术时间[（63±16.35）min比（39±12.34）min,t=1.765,P=0.041]、术后引流量[（120±23.36）ml比（60±16.45）ml,t=1.889,P=0.036]均大于开放组,差异有统计学意义。但腔镜组在术后颈部不适感（χ~2=7.832,P=0.007）、疼痛感（χ~2=4.478,P=0.034）及患者的心理接受（χ~2=11.801,P=0.001）上要优于开放组,差异有统计学意义。结论改良腔镜甲状腺手术无颈部手术瘢痕,患者容易接受,手术安全可靠,实施简单有效。
Objective To evaluate the clinical outcome of endoscopic thyroidectomy through the anterior region of the chest. Methods A total of 162 patients with thyroid nodules sized from 2 cm to 5 cm underwent thyroidectomy from December 2012 to June 2014. Of these patients,42 underwent improved endoscopic thyroidectomy through the anterior region of the chest and 120 underwent traditional thyroidectomy.Statistical analyses were performed using the SPSS version 17. 0 software package. The quantitative data were expressed as mean ± SD; they included age,size of nodule,postoperative hospital stay,operative time and postoperative drainage volume. Neck discomfort,pain,and satisfaction were compared using the Chi-square test. P values 0. 05 were considered statistically signicant. Results Fourty-one patients underwent improved endoscopic thyroidectomy successfully and one patient changed to open operation. Improved endoscopic thyroidectomy was better than traditional thyroidectomy in operation time [（ 63 ± 16. 35） min vs（ 39 ±12. 34） min,t =1. 765,P =0. 041]and postoperative drainage volume[（ 120 ± 23. 36） ml vs.（ 60 ±16. 45） ml,t = 1. 889,P = 0. 036]. There was no significant difference between the 2 groups. However improved endoscopic thyroidectomy showed better postoperative neck discomfort（ χ~2= 7. 832,P = 0. 007）,pain（ χ~2= 4. 478,P = 0. 034）,and psychological acceptance（ χ~2= 11. 801,P = 0. 001）,and there was no significant difference between the 2 groups. Conclusions Improved endoscopic thyroidectomy is easily performed because it is simple,reliable and free from formation of surgical scar.
出处
《中华普外科手术学杂志（电子版）》
2015年第6期50-52,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
