CAJ | 학술논문

目的：比较锁骨上侧入路甲状腺切除术与完全腔镜甲状腺切除术应用于甲状腺手术患者的临床效果。方法纳入2009年3月至2013年12月本院收治的167例需要施行甲状腺切除术的患者，根据病情结合患者意愿分为两组，分别采用锁骨上侧入路手术(n=99)和完全腔镜手术(n=68)。观察并比较两组患者手术时间、切口长度、术中出血量等各项指标，手术并发症发生情况，术后恢复及美容效果评价情况。结果①两组患者术中失血量比较差异无统计学意义(P>0.05)。腔镜手术组切口长度明显短于侧入路手术组，但手术时间明显长于腔镜手术组，差异均有统计学意义(P<0.05)；②侧入路手术组、腔镜手术组术后并发症发生率分别为2.02%、1.47%，差异无统计学意义(P>0.05)；③锁骨上侧入路组、完全腔镜手术组术后平均住院时间分别为(5.4±1.1) d，(4.5±0.9) d，术后颈部外观满意度评分分别为(7.2±1.1)分，(8.7±0.7)分，差异均无统计学意义(P>0.05)。结论经锁骨上侧入路途径行甲状腺切除术是安全可行的，与腔镜手术相比，适应证扩大，手术时间缩短，美容效果尚属满意。
목적：비교쇄골상측입로갑상선절제술여완전강경갑상선절제술응용우갑상선수술환자적림상효과。방법납입2009년3월지2013년12월본원수치적167례수요시행갑상선절제술적환자，근거병정결합환자의원분위량조，분별채용쇄골상측입로수술(n=99)화완전강경수술(n=68)。관찰병비교량조환자수술시간、절구장도、술중출혈량등각항지표，수술병발증발생정황，술후회복급미용효과평개정황。결과①량조환자술중실혈량비교차이무통계학의의(P>0.05)。강경수술조절구장도명현단우측입로수술조，단수술시간명현장우강경수술조，차이균유통계학의의(P<0.05)；②측입로수술조、강경수술조술후병발증발생솔분별위2.02%、1.47%，차이무통계학의의(P>0.05)；③쇄골상측입로조、완전강경수술조술후평균주원시간분별위(5.4±1.1) d，(4.5±0.9) d，술후경부외관만의도평분분별위(7.2±1.1)분，(8.7±0.7)분，차이균무통계학의의(P>0.05)。결론경쇄골상측입로도경행갑상선절제술시안전가행적，여강경수술상비，괄응증확대，수술시간축단，미용효과상속만의。
Objective To compare the clinical effect of supraclavicular lateral approach and endoscopic ap-proach for thyroidectomy. Methods A total of 167 patients with thyroid diseases who were admitted to our hospital from March 2009 to December 2013 were allocated to two groups according to patients' condition and willing:supraclavicular lateral approach group (n=99) and endoscopic approach group (n=68). Surgery time, length of incision, intraoperative blood loss, incidence of complications, postoperative recovery and cosmetic result between two groups were compared. Results ①The difference between intraoperative blood loss of the two groups was not statistically significant (P>0.05). The length of incision in endoscopic approach group was significantly shorter than that in supraclavicular lateral approach group, while surgery time in endoscopic approach group was longer than that in supraclavicular lateral approach group. The differences were both statistically significant (P<0.05).②The incidence of complications were 2.02%, 1.47%respec-tively in supraclavicular lateral approach group and endoscopic approach group, and the difference was not statistically sig-nificant (P>0.05).③Mean length of stay in supraclavicular lateral approach group and endoscopic approach group were (5.4±1.1) days and (4.5±0.9) days respectively, and satisfactory scores of neck appearance were (7.2±1.1) and (8.7±0.7) re-spectively. Both of the differences were not statistically significant (P>0.05). Conclusion The supraclavicular lateral ap-proach is a safe and feasible approach for thyroidectomy. It holds the advantages of extensive indication, short surgery time and acceptable cosmetic result compared with endoscopic approach.