CAJ | 학술논문

目的：研究超声刀经胸乳入路腔镜下行甲状腺癌根治术的效果及对并发症的影响。方法回顾性分析本院2012年7月~2014年7月行手术治疗的104例甲状腺癌患者，采用传统开放手术的患者为对照组，采用超声刀经胸乳入路腔镜下行甲状腺癌根治术的患者为观察组，比较两组患者的术中出血量、手术时间、术后引流量及住院时间、术后疼痛及并发症发生情况。结果观察组的术中出血量、术后引流量显著少于对照组，手术时间、住院时间均显著短于对照组(P<0.05)；观察组术后3 d内的疼痛评分低于对照组(P<0.05)。观察组术后声音嘶哑、暂时性低钙、手足麻木、发音困难并发症发生率与对照组差异无统计学意义(P>0.05)，但术后总并发症发生率显著低于对照组(P<0.05)。结论超声刀经胸乳入路腔镜下行甲状腺癌根治术具有术中出血量少、手术时间短、术后引流量少、住院时间短、术后前期患者疼痛较轻以及术后并发症发生率低等优势，手术效果可靠，是甲状腺癌较为理想的治疗方式。
목적：연구초성도경흉유입로강경하행갑상선암근치술적효과급대병발증적영향。방법회고성분석본원2012년7월~2014년7월행수술치료적104례갑상선암환자，채용전통개방수술적환자위대조조，채용초성도경흉유입로강경하행갑상선암근치술적환자위관찰조，비교량조환자적술중출혈량、수술시간、술후인류량급주원시간、술후동통급병발증발생정황。결과관찰조적술중출혈량、술후인류량현저소우대조조，수술시간、주원시간균현저단우대조조(P<0.05)；관찰조술후3 d내적동통평분저우대조조(P<0.05)。관찰조술후성음시아、잠시성저개、수족마목、발음곤난병발증발생솔여대조조차이무통계학의의(P>0.05)，단술후총병발증발생솔현저저우대조조(P<0.05)。결론초성도경흉유입로강경하행갑상선암근치술구유술중출혈량소、수술시간단、술후인류량소、주원시간단、술후전기환자동통교경이급술후병발증발생솔저등우세，수술효과가고，시갑상선암교위이상적치료방식。
Objective To study the effect of thyroid cancer radical mastectomy using harmonic scalpel by pectoral breast approch under thoracoscopy and the influence of surgery on complication. Methods 104 patients with thyroid cancer treated by surgery from July 2012 to July 2014 were retrospectively analyzed,control group was given traditional open surgery,and observation group was given thyroid cancer radical mastectomy by pectoral breast approch under tho-racoscopy.Amount of bleeding during operation, operative time,postoperative drainage volume and hospital stay,postop-erative pain and complication in patients between two groups were compared. Results Amount of bleeding during oper-ation,postoperative drainage volume in observation group was obviously less than that of control group respectively,oper-ative time and hospital stay was obviously shorter than that of control group respectively (P<0.05).The postoperative pain score within 3 days after operation in observation group was lower than that of control group (P<0.05).There was no statistical difference of the incidence rate of complication (hoarseness,temporary low calcium,deadlimb,and pronun-ciation difficulty) after operation between two groups (P>0.05),but the total incidence rate of postoperative complication in observation group was significantly lower than that of control group (P<0.05). Conclusion Thyroid cancer radical mastectomy by pectoral breast approch under thoracoscopy has the advantage of less amount of bleeding during opera-tion,shorter operation stay,less postoperative drainage volume,and shorter hospital stay and lighter pain in early stage after operation and lowed incidence rate of postoperative complication,operation effect is reliable.It is ideal treatment method in thyroid cancer.