CAJ | 학술논문

目的比较腔镜和开放两种甲状腺大部分切除术治疗甲状腺机能亢进症的临床价值.方法回顾性分析64例采用双乳晕、左腋三孔法腔镜甲状腺大部分切除术(ET组)和63例开放甲状腺大部分切除术(OT组)治疗原发性甲状腺机能亢进症的临床资料.结果两组年龄、性别、病程、术前甲状腺肿大程度、并发症及T_3、T_4、TSH水平等方面差异无统计学意义(P>0.05),具有可比性.所有手术均获成功,ET组无中转.两组住院时间比较,差异无统计学意义.ET组失血量(88.2+67.3)ml明显少于OT组(122.2 ±62.8)ml,而ET组手术时间(115.2±24.6)min长于OT组(93.4±38.1)min,引流量(144.04±38.72)ml多于OT组(84.86±76.11)ml,ET组住院总费用(10596.1±1526.3)元多于OT组(66359.9±5885.9)元,差异有统计学意义(P<0.05).ET组发生一过性声音嘶哑6例,OT组3例,无其他严重并发症.所有患者均获随访,平均48.6个月,ET组出现甲低3例和甲亢复发4例,OT组甲低4例和甲亢复发2例.结论选择合适的病例实施腔镜治疗原发性甲状腺功能亢进安全、可行,具有美容、疼痛轻、出血少的优点.
목적 비교강경화개방량충갑상선대부분절제술치료갑상선궤능항진증적림상개치.방법 회고성분석64례채용쌍유훈、좌액삼공법강경갑상선대부분절제술(ET조)화63례개방갑상선대부분절제술(OT조)치료원발성갑상선궤능항진증적림상자료.결과 량조년령、성별、병정、술전갑상선종대정도、병발증급T_3、T_4、TSH수평등방면차이무통계학의의(P>0.05),구유가비성.소유수술균획성공,ET조무중전.량조주원시간비교,차이무통계학의의.ET조실혈량(88.2+67.3)ml명현소우OT조(122.2 ±62.8)ml,이ET조수술시간(115.2±24.6)min장우OT조(93.4±38.1)min,인류량(144.04±38.72)ml다우OT조(84.86±76.11)ml,ET조주원총비용(10596.1±1526.3)원다우OT조(66359.9±5885.9)원,차이유통계학의의(P<0.05).ET조발생일과성성음시아6례,OT조3례,무기타엄중병발증.소유환자균획수방,평균48.6개월,ET조출현갑저3례화갑항복발4례,OT조갑저4례화갑항복발2례.결론 선택합괄적병례실시강경치료원발성갑상선공능항진안전、가행,구유미용、동통경、출혈소적우점.
Objective To compare endoscopic thyroidectomy(ET)with conventional open thyroidectomy(OT)for treatment of primary hyperthyroidism.Methods Total of 127 patients with primary hyperthyroidism had thyroidectomy in our hospital from January 2003 to May 2008.Among them,64 patients underwent ET(group ET)and 63 had OT(group OT)and their clinical data were analyzed retrospectively.Results There was no significantly difference in age,sex,disease course,size of thyroid,complication and T_3,T_4,TSH level(P>0.05).All operations were successfully carried out.Operation time was longer in group ET(115.2±24.6)rain than that in group OT(93.4±38.1)min(P<0.5).Blood loss in group ET was significantly less(88.2±67.3)ml than group OT(122.2±62.8)ml(P<0.5),but the drainage volume in group ET(144.04±38.72)ml was more than group OT(84.86±76.11)ml(P<0.05).The cost of hospitalization in group ET was higher than OT but there was no significantly difference in hospital stay between two groups.6 cases in group ET and 3 cases in group OT had temporary hoarseness but no significant difference was found.No erious complications in all cases.3 hypothyroidism and 4 recurrent hyperthyroidism occurred in group ET while 4 hypothyroidism and 2 recurrent hyperthyroidism in group OT during a48.6 month's follow-up.Conclusions If suitable case is selected,ET is a feasible and safe therapy for primary hyperthyroidism and has an advantage of good cosmetic result,less pain and less blood loss.