CAJ | 학술논문

目的：探讨不横断颈前肌群的方法在经胸乳入路腔镜甲状腺切除手术中的应用价值。方法对昆明医科大学第二附属医院130例采用不横断颈前肌群方法甲状腺手术患者的临床资料进行回顾性分析，其中经胸乳入路腔镜甲状腺切除手术68例（腔镜手术组），传统甲状腺切除手术62例（传统手术组）。结果腔镜手术组手术时间（127．66±29．56）min较传统手术组（89．06±24．25）min长（P＜0．01），术中出血量（19．13±7．37）mL较传统手术组（50．17±29．28）mL少（P＜0．01）；腔镜手术组术后出现颈部痛性硬结1例较传统手术组7例少（P＜0．01）；腔镜手术组术后神经功能障碍4例，传统手术组3例，差异无统计学意义（P＞0．05）。结论经胸乳入路腔镜甲状腺手术不横断颈前肌群具有术中出血少、颈部痛性硬结发生率低、切口隐蔽、美容效果好等优点，手术安全可行。
목적：탐토불횡단경전기군적방법재경흉유입로강경갑상선절제수술중적응용개치。방법대곤명의과대학제이부속의원130례채용불횡단경전기군방법갑상선수술환자적림상자료진행회고성분석，기중경흉유입로강경갑상선절제수술68례（강경수술조），전통갑상선절제수술62례（전통수술조）。결과강경수술조수술시간（127．66±29．56）min교전통수술조（89．06±24．25）min장（P＜0．01），술중출혈량（19．13±7．37）mL교전통수술조（50．17±29．28）mL소（P＜0．01）；강경수술조술후출현경부통성경결1례교전통수술조7례소（P＜0．01）；강경수술조술후신경공능장애4례，전통수술조3례，차이무통계학의의（P＞0．05）。결론경흉유입로강경갑상선수술불횡단경전기군구유술중출혈소、경부통성경결발생솔저、절구은폐、미용효과호등우점，수술안전가행。
Objective To explore the application value of endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group .Methods The clinical data of 130 patients which treated by thyroidectomy without transection ante‐rior cervical muscle group were analyzed ,retrospectively .There were 68 cases treated by endoscopic thyroidectomy via breast ap‐proach and 62 cases treated by conventional thyroidectomy .Results 68 patients underwent endoscopic thyroidectomy ,the mean time of operation was(127 .66 ± 29 .56)min ,which was longer than that in conventional group (89 .06 ± 24 .25)min(P<0 .01) ,but blood loss was significantly less in endoscopy group than that in conventional group(19 .13 ± 7 .37)mL vs .(50 .17 ± 29 .28)mL . (P<0 .01) .The patients treated by endoscopic thyroidectomy with neck pain induration were less than that in conventional group (1 case vs .7 case) ,P<0 .01 ,and the nerve dysfunction were (4 case vs .3 case) ,P>0 .05 ,the nerve dysfunction had no significant difference .Conclusion Endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group has less blood loss ,lower neck pain induration rate ,hidden incisions and excellent cosmetic benefits .The method is safe and feasible .