CAJ | 학술논문

目的：分析全腔镜与腔镜辅助小切口技术在甲状腺手术中应用的优劣势，为甲状腺及旁腺疾病手术治疗提供依据。方法选择2011年6月~2013年12月间我院行甲状腺切除手术的患者共406例，按患者对手术的意愿分为全腔镜组和腔镜辅助组。比较两组的手术时间、第1 d 引流量、引流总量、引流时间、住院天数以及住院费用，术后5个月评价患者手术效果及满意度。结果全腔镜组手术时间长于腔镜辅助组，患者第1 d 引流量、引流总量多于腔镜辅助组，引流时间、住院天数短于腔镜辅助组，费用多于腔镜辅助组，差异均具有统计学意义（P ﹤0.05）；全腔镜组“颈部感觉减退”、“颈前皮肤紧张感”评分低于腔镜辅助组，但“术后满意度”评分高于腔镜辅助组（P ﹤0.05）。结论全腔镜手术与腔镜辅助小切口手术均对甲状腺手术安全有效，但全腔镜手术对患者容貌影响更小，而腔镜辅助小切口技术则更简捷高效，对患者身体伤害更小，需根据患者意愿及个体情况进行选择。
목적：분석전강경여강경보조소절구기술재갑상선수술중응용적우열세，위갑상선급방선질병수술치료제공의거。방법선택2011년6월~2013년12월간아원행갑상선절제수술적환자공406례，안환자대수술적의원분위전강경조화강경보조조。비교량조적수술시간、제1 d 인류량、인류총량、인류시간、주원천수이급주원비용，술후5개월평개환자수술효과급만의도。결과전강경조수술시간장우강경보조조，환자제1 d 인류량、인류총량다우강경보조조，인류시간、주원천수단우강경보조조，비용다우강경보조조，차이균구유통계학의의（P ﹤0.05）；전강경조“경부감각감퇴”、“경전피부긴장감”평분저우강경보조조，단“술후만의도”평분고우강경보조조（P ﹤0.05）。결론전강경수술여강경보조소절구수술균대갑상선수술안전유효，단전강경수술대환자용모영향경소，이강경보조소절구기술칙경간첩고효，대환자신체상해경소，수근거환자의원급개체정황진행선택。
Objective To discuss the advantages and disadvantages of endoscopic thyroidectomy and endoscope-assisted thyroidectomy with small incision. Methods 406 cases hospitalized in the period from June,2011 to Dec. ,2013 to receive thyroidectomy were divided,according to the choice of the patients,into 2 groups:endoscope group and endoscope-assisted group;a comparison in operation time,the drainage volume on the first day,the total drainage volume,the time of drainage,hospitalization duration and expenses was made between the 2 groups;the surgical effect and the satisfaction of the patients were evaluated 5 months after operation. Results The operation time in endoscope group was longer than that in endoscope-assisted group and the drainage volume on the first day and the total drainage volume were bigger than those in endoscope-assisted group;the time of drainage and hospitalization duration in endoscope group were shorter than those in endoscope-assisted group,while the expenses was higher than that in endoscope-assisted group;the difference between the 2 groups was of statistical significance(P ﹤ 0. 05);the scores of hypesthesia in neck and tension in anterior cervical skin in endoscope group were lower while that of satisfaction was higher than those in endoscope-assisted group(P ﹤ 0. 05). Conclusions Both endoscopic thyroidectomy and endoscope-assisted thyroidectomy with small incision are safe and effective;endoscopic thyroidectomy has less impact on the appearance of the patients,while endoscope-assisted thyroidectomy with small incision is simpler in operation with higher effect and less harm to the bodies of the patients;the selection should be made according to the choice and the conditions of the patients.