中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2015年
12期
86-88
,共3页
甲状腺疾病%腔镜%外科手术
甲狀腺疾病%腔鏡%外科手術
갑상선질병%강경%외과수술
Benign thyroid nodule%Endoscopy%Surgery
目的：探讨腔镜辅助颈部小切口手术治疗甲状腺疾病的效果。方法选择2009年1月~2014年10月河北联合大学附属医院曹妃甸区医院收治的单侧甲状腺良性肿瘤患者87例，按手术方法，分为传统组（41例）和腔镜组（46例）。传统组采用传统开放式方法行单侧甲状腺部分切除术，腔镜组采用腔镜辅助颈部小切口甲状腺手术。比较两组患者的手术时间、术中出血量、术后24 h视觉模拟评分（VAS）、术后引流量、手术并发症、住院费用及切口美容VAS评分。结果传统组与腔镜组手术时间、手术并发症比较[（72.1±24.8）min比（83.7±25.6）min，4.9%比2.2%]，差异均无统计学意义（P>0.05）。与传统组比较，腔镜组患者术中出血量少，术后引流量少，住院费用高[（27.0±12.9）mL比（49.1±23.8）mL，（30.9±7.9）mL比（80.9±16.2）mL，（9805.3±700.8）元比（8690.8±630.6）元]，差异均有统计学意义（P<0.05）；术后24 h VAS评分低、切口美容VAS评分高[（3.1±1.4）分比（5.2±2.0）分，（7.9±0.7）分比（2.0±0.8）分]，差异均有统计学意义（P<0.05）。结论腔镜辅助下的甲状腺手术充分体现了美容、微创的优势，是一种安全、可靠的甲状腺手术方式。
目的：探討腔鏡輔助頸部小切口手術治療甲狀腺疾病的效果。方法選擇2009年1月~2014年10月河北聯閤大學附屬醫院曹妃甸區醫院收治的單側甲狀腺良性腫瘤患者87例，按手術方法，分為傳統組（41例）和腔鏡組（46例）。傳統組採用傳統開放式方法行單側甲狀腺部分切除術，腔鏡組採用腔鏡輔助頸部小切口甲狀腺手術。比較兩組患者的手術時間、術中齣血量、術後24 h視覺模擬評分（VAS）、術後引流量、手術併髮癥、住院費用及切口美容VAS評分。結果傳統組與腔鏡組手術時間、手術併髮癥比較[（72.1±24.8）min比（83.7±25.6）min，4.9%比2.2%]，差異均無統計學意義（P>0.05）。與傳統組比較，腔鏡組患者術中齣血量少，術後引流量少，住院費用高[（27.0±12.9）mL比（49.1±23.8）mL，（30.9±7.9）mL比（80.9±16.2）mL，（9805.3±700.8）元比（8690.8±630.6）元]，差異均有統計學意義（P<0.05）；術後24 h VAS評分低、切口美容VAS評分高[（3.1±1.4）分比（5.2±2.0）分，（7.9±0.7）分比（2.0±0.8）分]，差異均有統計學意義（P<0.05）。結論腔鏡輔助下的甲狀腺手術充分體現瞭美容、微創的優勢，是一種安全、可靠的甲狀腺手術方式。
목적：탐토강경보조경부소절구수술치료갑상선질병적효과。방법선택2009년1월~2014년10월하북연합대학부속의원조비전구의원수치적단측갑상선량성종류환자87례，안수술방법，분위전통조（41례）화강경조（46례）。전통조채용전통개방식방법행단측갑상선부분절제술，강경조채용강경보조경부소절구갑상선수술。비교량조환자적수술시간、술중출혈량、술후24 h시각모의평분（VAS）、술후인류량、수술병발증、주원비용급절구미용VAS평분。결과전통조여강경조수술시간、수술병발증비교[（72.1±24.8）min비（83.7±25.6）min，4.9%비2.2%]，차이균무통계학의의（P>0.05）。여전통조비교，강경조환자술중출혈량소，술후인류량소，주원비용고[（27.0±12.9）mL비（49.1±23.8）mL，（30.9±7.9）mL비（80.9±16.2）mL，（9805.3±700.8）원비（8690.8±630.6）원]，차이균유통계학의의（P<0.05）；술후24 h VAS평분저、절구미용VAS평분고[（3.1±1.4）분비（5.2±2.0）분，（7.9±0.7）분비（2.0±0.8）분]，차이균유통계학의의（P<0.05）。결론강경보조하적갑상선수술충분체현료미용、미창적우세，시일충안전、가고적갑상선수술방식。
Objective To discuss the effect of minimally invasive endoscopic-assisted thyroidectomy (EAT) in the treat-ment of benign thyroid nodules. Methods From January 2009 to October 2014, in Caofeidian Affiliated Hospital of Hebei United University, 87 patients with one-side benign thyroid nodules were divided into tradition group (n=41) amd EAT group (n=46), according to the operation method. EAT group was treated with minimally invasive endoscopic-assisted thyroidectomy and tradition group was treated with conventional open thyroidectomy. The duration of operation, intraoperative blood loss, visual analog scores (VAS) for paln severity, volume of dralnage, occurrence of postoperative complications, hospital expense, VAS for cosmetic were compared in two groups respectively. Results The duration of operation, occurrence of postoperative complications of tradition group and EAT group were compared [(72.1±24.8) min vs (83.7±25.6) min, 4.9% vs 2.2%], the differences were not statistically significant (P> 0.05). Compared with tradition group, intraoperative blood loss, volume of dralnage were less, hospital expense was more in EAT group [(27.0±12.4) mL vs (49.1±23.8) mL, (30.9±7.9) mL vs (80.9±16.2) mL, (9805.3±700.8) yuan vs (8690.8±630.6) yuan], the differences were statistically significant (P<0.05);VAS for paln severity was lower, VAS for cosmetic was higher [(3.1±1.4) scores vs (5.2±2.0) scores, (7.9±0.7) scores vs (2.0±0.8) scores], the differences were statistically significant (P<0.05). Conclusion EAT is a safe and feasible thyroid surgery, which fully reflects the advantages of minimally invasive and cosmetic effect.
