CAJ | 학술논문

目的：探讨超声刀经胸乳入路腔镜下行甲状腺癌根治术的临床疗效及安全性。方法按就诊顺序编号将我院2012年2月～2014年2月收治的48例甲状腺癌患者分为对照组（24例）和观察组（24例），其中对照组行传统开放手术治疗，观察组采用超声刀经胸乳入路腔镜下行甲状腺癌根治术治疗，比较两组患者的临床治疗效果。结果两种术式的手术时间比较差异无统计学意义（P＞0.05）；对照组的术中出血量多于观察组，术后引流时间和住院时间长于观察组，并发症发生率也高于观察组，比较差异均具有统计学意义（P＜0.05）；术后疼痛评分显示，观察组术后第1天和第3天的疼痛评分均低于对照组，差异具有统计学意义（P＜0.05），两组患者第5天的疼痛评分差异无统计学意义（P＞0.05）。结论采用超声刀经胸乳入路腔镜下行甲状腺癌根治术可缩短术后引流及住院时间，降低并发症发生率，同时对患者的创伤较小，术后疼痛较轻，值得临床借鉴和推广。
목적：탐토초성도경흉유입로강경하행갑상선암근치술적림상료효급안전성。방법안취진순서편호장아원2012년2월～2014년2월수치적48례갑상선암환자분위대조조（24례）화관찰조（24례），기중대조조행전통개방수술치료，관찰조채용초성도경흉유입로강경하행갑상선암근치술치료，비교량조환자적림상치료효과。결과량충술식적수술시간비교차이무통계학의의（P＞0.05）；대조조적술중출혈량다우관찰조，술후인류시간화주원시간장우관찰조，병발증발생솔야고우관찰조，비교차이균구유통계학의의（P＜0.05）；술후동통평분현시，관찰조술후제1천화제3천적동통평분균저우대조조，차이구유통계학의의（P＜0.05），량조환자제5천적동통평분차이무통계학의의（P＞0.05）。결론채용초성도경흉유입로강경하행갑상선암근치술가축단술후인류급주원시간，강저병발증발생솔，동시대환자적창상교소，술후동통교경，치득림상차감화추엄。
Objective To explore the clinical effect and safety of endoscopic radical operation for thyroid carcinoma with ultrasonic knife via thoracic and mammary approach. Methods 48 patients with thyroid carcinoma who were admitted to our hospital from February 2012 to February 2014 were allocated to a control group and an observation group according to their admission order, with 24 patients in each group. The control group received conventional open surgery, while the observation group received endoscopic radical operation for thyroid carcinoma with ultrasonic knife via thoracic and mammary approach. The clinical effects between the two groups were compared. Results Difference of surgery time of the two types of surgery was not statistically significant(P > 0.05); the amount of bleeding in the control group was larger than that in the observation group, postoperative drainage time and hospitalization time were longer than those in the observation group, and the incidence of complications was also higher than that in the observation group. The differences were all statistically significant(P<0.05);pain scores in the observation group in the first day and third day after the surgery were both lower than those in the control group, and the differences were statistically significant(P<0.05). Difference of the pain scores in the fifth day in the two groups was not statistically significant(P > 0.05). Conclusion Endoscopic radical operation for thyroid carcinoma with ultrasonic knife via thoracic and mammary approach helps shorten postoperative drainage time and hospitalization time and lower the incidence of complications. It also has minor trauma with less pain for patients and is therefore worthy of clinical application and promotion.