CAJ | 학술논문

目的：研究对比全腔镜( CE)与腔镜辅助小切口术式( EASIO)在甲状腺手术中的应用。方法选择2010年9月至2013年9月我院收治的甲状腺患者279例作为研究对象,其中239例接受甲状腺手术,根据手术方式分为CE组( n=95)和EASIO组(n=144)。另40例接受甲状旁腺手术,根据手术方式分为CE组(n=5)和EASIO组(n=35)。对比CE及EASIO术式在甲状腺病症中的手术相关指标,CE及EASIO术式应用于甲状腺病症的术后结果,以及CE及EASIO术式应用于甲状旁腺的情况。结果关于甲状腺病症,CE组的女性比例、腺瘤或单侧腺叶切除者比例、甲状腺体积、结节最长径、腺瘤或腺叶切除时间、双叶次全切或全切时间及术中出血量均显著高于 EASIO 组,而年龄、双叶次全切或全切比例均显著低于 EASIO 组,差异有统计学意义(P<0.05)。 CE组的前胸不适比例、VAS术后疼痛评分、住院时间及美容效果的满意评分均显著高于EASIO组,差异有统计学意义(P<0.05)。关于甲状旁腺病症,CE组的年龄显著低于EASIO组,但手术时间及住院时间均显著高于EASIO组,差异有统计学意义(P<0.05)。结论甲状腺手术中应用CE及EASIO术式治疗各有优劣势,应综合考虑患者病情及自身要求,制订最佳手术方案。
목적：연구대비전강경( CE)여강경보조소절구술식( EASIO)재갑상선수술중적응용。방법선택2010년9월지2013년9월아원수치적갑상선환자279례작위연구대상,기중239례접수갑상선수술,근거수술방식분위CE조( n=95)화EASIO조(n=144)。령40례접수갑상방선수술,근거수술방식분위CE조(n=5)화EASIO조(n=35)。대비CE급EASIO술식재갑상선병증중적수술상관지표,CE급EASIO술식응용우갑상선병증적술후결과,이급CE급EASIO술식응용우갑상방선적정황。결과관우갑상선병증,CE조적녀성비례、선류혹단측선협절제자비례、갑상선체적、결절최장경、선류혹선협절제시간、쌍협차전절혹전절시간급술중출혈량균현저고우 EASIO 조,이년령、쌍협차전절혹전절비례균현저저우 EASIO 조,차이유통계학의의(P<0.05)。 CE조적전흉불괄비례、VAS술후동통평분、주원시간급미용효과적만의평분균현저고우EASIO조,차이유통계학의의(P<0.05)。관우갑상방선병증,CE조적년령현저저우EASIO조,단수술시간급주원시간균현저고우EASIO조,차이유통계학의의(P<0.05)。결론갑상선수술중응용CE급EASIO술식치료각유우열세,응종합고필환자병정급자신요구,제정최가수술방안。
Objective To study the advantages and disadvantages of the application of complete endoscopic and endoscope assisted small incision in thyroid surgery. Methods From September 2010 to September 2013,279 patients with thyroid diseases in our hospital were selected as the research object. Among them,239 cases of thyroid surgery were grouped according to the surgical method,the complete endo-scopic group with 95 cases,endoscope assisted small incision surgery group with 144 cases. The other 40 cases of parathyroid surgery were grouped according to the surgical method,the complete endoscopic group with 5 cases,endoscope assisted small incision group with 35 cases. The results and indicators related to the surgery with the complete endoscopic and endoscope assisted small incision for the thyroid disease and parathyroid gland were compared. Results About thyroid disease,the proportion of women in the complete endoscopic group,the adeno-ma or unilateral gland leaf proportion,thyroid volume,the tumor nodules longest diameter,adenoma or glandular lobe resection time,double leaf full cut or full cutting time and intraoperative blood loss were significantly higher than that of endoscope assisted small incision group,and the age,double leaf time full cut or full cut rate were significantly lower than that of endoscope assisted small incision group,the differences were statistically significant (P<0. 05). About thyroid disease,proportion of chest discomfort,VAS pain score,length of hospital stay and postoperative cosmetic effect of satisfaction scores in complete endoscopic group were significantly higher than that of endoscopy assisted small incision group,the differences were statistically significant (P<0. 05). About parathyroid disease,the age of patients in the complete endo-scopic group was significantly lower than that in endoscopy assisted small incision group,but the operation time and hospital stay were signifi-cantly higher than that of endoscopy assisted small incision group,the differences were statistically significant (P<0. 05). Conclusion The thyroid surgery with complete endoscopic and endoscopy assisted small incision has certain advantages and disadvantages,which should be considered for patients demands,so as to make the best operation program.