中华腔镜外科杂志（电子版）
中華腔鏡外科雜誌（電子版）
중화강경외과잡지（전자판）
CHINESE JOURNAL OF LAPAROSCOPIC SURGERY ( ELECTRONIC EDITION)
2014年
5期
364-367
,共4页
刘洪涛%蔡相军%刘亮%王斌%印慨%郑成竹
劉洪濤%蔡相軍%劉亮%王斌%印慨%鄭成竹
류홍도%채상군%류량%왕빈%인개%정성죽
甲状腺%腔镜%胸壁入路
甲狀腺%腔鏡%胸壁入路
갑상선%강경%흉벽입로
Thyroid%Endoscopic%Transthoracic approach
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。方法选择甲状腺良性肿瘤130例，随机分为经胸壁入路腔镜甲状腺切除术58例（腔镜组）和开放切除术72例（开放组）。观察比较两组手术时间、术中出血量、术后住院时间、术后引流量、引流时间、住院费用、术后美容效果、术后并发症发生情况、术后疼痛评分及患者满意度等。结果开放组住院时间、切口长度显著多（长）于腔镜组（P ＜0．05），出血量、手术时间、拔管时间、住院费用、引流量、术后疼痛 VAS 分值显著少（短）于腔镜组（P ＜0．05）。两组术后并发症发生率、肿瘤复发率比较，差异无统计学意义。腔镜组患者美观满意度显著高于开放组（P ＜0．05）。结论经胸壁入路腔镜甲状腺切除术临床效果优于开放切除术，在严格把握手术适应证的情况下是值得推崇的手术方式。
目的：比較完全腔鏡與常規開放甲狀腺切除術之間的差彆，探討腔鏡下甲狀腺手術的可行性和實用性。方法選擇甲狀腺良性腫瘤130例，隨機分為經胸壁入路腔鏡甲狀腺切除術58例（腔鏡組）和開放切除術72例（開放組）。觀察比較兩組手術時間、術中齣血量、術後住院時間、術後引流量、引流時間、住院費用、術後美容效果、術後併髮癥髮生情況、術後疼痛評分及患者滿意度等。結果開放組住院時間、切口長度顯著多（長）于腔鏡組（P ＜0．05），齣血量、手術時間、拔管時間、住院費用、引流量、術後疼痛 VAS 分值顯著少（短）于腔鏡組（P ＜0．05）。兩組術後併髮癥髮生率、腫瘤複髮率比較，差異無統計學意義。腔鏡組患者美觀滿意度顯著高于開放組（P ＜0．05）。結論經胸壁入路腔鏡甲狀腺切除術臨床效果優于開放切除術，在嚴格把握手術適應證的情況下是值得推崇的手術方式。
목적：비교완전강경여상규개방갑상선절제술지간적차별，탐토강경하갑상선수술적가행성화실용성。방법선택갑상선량성종류130례，수궤분위경흉벽입로강경갑상선절제술58례（강경조）화개방절제술72례（개방조）。관찰비교량조수술시간、술중출혈량、술후주원시간、술후인류량、인류시간、주원비용、술후미용효과、술후병발증발생정황、술후동통평분급환자만의도등。결과개방조주원시간、절구장도현저다（장）우강경조（P ＜0．05），출혈량、수술시간、발관시간、주원비용、인류량、술후동통 VAS 분치현저소（단）우강경조（P ＜0．05）。량조술후병발증발생솔、종류복발솔비교，차이무통계학의의。강경조환자미관만의도현저고우개방조（P ＜0．05）。결론경흉벽입로강경갑상선절제술림상효과우우개방절제술，재엄격파악수술괄응증적정황하시치득추숭적수술방식。
Objective To compare the differences between total endoscopic and conventional open thyroidectomy,as well as exploring the feasibility and efficacy of endoscopic surgery.Methods 130 cases of benign thyroid were chosen randomly and divided into two groups:58 cases of transthoracic endoscopic thyroidectomy (laparoscopic group)and 72 cases of open surgery (open group).To compare the difference of operative time,blood loss,postoperative hospital stay,postoperative drainage,drainage time,hospital costs,postoperative cosmetic results,postoperative complications,postoperative pain scores and patient satisfaction in two groups.Results In open group,hospital stay and incision length were significantly more /longer than those in laparoscopic group (P <0.05),blood loss operative time,extubation time,hospital costs,drainage and postoperative pain VAS score were significantly less /shorter than laparoscopic group (P <0.05).The two groups have no difference in the incidence of postoperative complications and recurrence rate.Patients are very beautiful and full-scale in laparoscopic group,extremely higher than the open group (P <0.05).Conclusion Under strict control of its applicability,transthoracic approach endoscopic thyroidectomy should be worthy of recommendable surgery,which is better than open surgery.
