现代肿瘤医学
現代腫瘤醫學
현대종류의학
Journal of Modern Oncology
2015年
24期
3585-3588
,共4页
张轶%李正凯%李洪涛%韩晓鹏%苏琳%刘宏斌
張軼%李正凱%李洪濤%韓曉鵬%囌琳%劉宏斌
장질%리정개%리홍도%한효붕%소림%류굉빈
胸乳入路%腔镜甲状腺手术%开放甲状腺手术%手术治疗
胸乳入路%腔鏡甲狀腺手術%開放甲狀腺手術%手術治療
흉유입로%강경갑상선수술%개방갑상선수술%수술치료
trans -thoracoareolar approach%endoscopic thyroidectomy%conventional open thyroidectomy%surgical treatment
目的:对比经胸乳入路腔镜甲状腺手术与传统甲状腺手术的临床疗效,探讨经胸乳入路腔镜甲状腺手术的可行性和优势。方法:回顾性分析了2011年12月至2014年3月收治的314例接受手术治疗的甲状腺良性肿瘤患者的临床资料,其中腔镜组78例,行经胸乳入路腔镜甲状腺手术;开放组236例,行传统开放性甲状腺手术。采用统计学方法对两组手术时间、术中出血量、术后第一天引流量、使用止痛药物情况、术后并发症、术后住院时间情况进行对比分析,并进行术后随访。结果:腔镜组手术时间为(82.0±23.5)min,长于开放组(57.7±13.7)min,差异有统计学意义(P <0.01);腔镜组术中出血量(13.9±7.6)ml 低于开放组(33.9±15.4)ml,差异有统计学意义(P <0.01);术后第一天出血量(22.3±8.7)ml 少于开放组(36.0±17.8)ml,差异有统计学意义(P <0.01);术后住院时间分别为(2.4±0.9)天和(3.6±1.2)天,差异有统计学意义(P <0.01);腔镜组患者术后使用止痛药的比例小于开放组;腔镜组术后无严重并发症,并发症发生率与开放组无差异且均较低,术后随访半年,未出现甲状腺功能减退和复发。结论:经胸乳入路腔镜甲状腺手术是一种安全、可靠的手术方式,具有出血少、住院时间短、疼痛轻和颈部无疤痕等优势。
目的:對比經胸乳入路腔鏡甲狀腺手術與傳統甲狀腺手術的臨床療效,探討經胸乳入路腔鏡甲狀腺手術的可行性和優勢。方法:迴顧性分析瞭2011年12月至2014年3月收治的314例接受手術治療的甲狀腺良性腫瘤患者的臨床資料,其中腔鏡組78例,行經胸乳入路腔鏡甲狀腺手術;開放組236例,行傳統開放性甲狀腺手術。採用統計學方法對兩組手術時間、術中齣血量、術後第一天引流量、使用止痛藥物情況、術後併髮癥、術後住院時間情況進行對比分析,併進行術後隨訪。結果:腔鏡組手術時間為(82.0±23.5)min,長于開放組(57.7±13.7)min,差異有統計學意義(P <0.01);腔鏡組術中齣血量(13.9±7.6)ml 低于開放組(33.9±15.4)ml,差異有統計學意義(P <0.01);術後第一天齣血量(22.3±8.7)ml 少于開放組(36.0±17.8)ml,差異有統計學意義(P <0.01);術後住院時間分彆為(2.4±0.9)天和(3.6±1.2)天,差異有統計學意義(P <0.01);腔鏡組患者術後使用止痛藥的比例小于開放組;腔鏡組術後無嚴重併髮癥,併髮癥髮生率與開放組無差異且均較低,術後隨訪半年,未齣現甲狀腺功能減退和複髮。結論:經胸乳入路腔鏡甲狀腺手術是一種安全、可靠的手術方式,具有齣血少、住院時間短、疼痛輕和頸部無疤痕等優勢。
목적:대비경흉유입로강경갑상선수술여전통갑상선수술적림상료효,탐토경흉유입로강경갑상선수술적가행성화우세。방법:회고성분석료2011년12월지2014년3월수치적314례접수수술치료적갑상선량성종류환자적림상자료,기중강경조78례,행경흉유입로강경갑상선수술;개방조236례,행전통개방성갑상선수술。채용통계학방법대량조수술시간、술중출혈량、술후제일천인류량、사용지통약물정황、술후병발증、술후주원시간정황진행대비분석,병진행술후수방。결과:강경조수술시간위(82.0±23.5)min,장우개방조(57.7±13.7)min,차이유통계학의의(P <0.01);강경조술중출혈량(13.9±7.6)ml 저우개방조(33.9±15.4)ml,차이유통계학의의(P <0.01);술후제일천출혈량(22.3±8.7)ml 소우개방조(36.0±17.8)ml,차이유통계학의의(P <0.01);술후주원시간분별위(2.4±0.9)천화(3.6±1.2)천,차이유통계학의의(P <0.01);강경조환자술후사용지통약적비례소우개방조;강경조술후무엄중병발증,병발증발생솔여개방조무차이차균교저,술후수방반년,미출현갑상선공능감퇴화복발。결론:경흉유입로강경갑상선수술시일충안전、가고적수술방식,구유출혈소、주원시간단、동통경화경부무파흔등우세。
Objective:To compare the clinical efficiency of endoscopic thyroidectomy by trans -thoracoareolar ap-proach with conventional open thyroidectomy,to explore the feasibility and advantage of endoscopic thyroidectomy. Methods:The clinical data of 314 cases of benign thyroid tumor patients who treated with surgery from December 2011 to March 2014 were analyzed retrospectively(endoscopy group:78 cases of endoscopic thyroidectomy by trans -thoracoareolar approach,open group:236 cases of conventional open thyroidectomy,).Operative time,blood loss,the volume of drainage in the first day after operation,use of painkillers,postoperative complications,time of postoperative stay and postoperative follow -up studies were compared.Results:The operation time in group endoscopy was(82.0 ±23.5)min,longer than open group(57.7 ±13.7)min,the difference was statistically significant(P <0.05).The blood loss of endoscopy group was (13.9 ±7.6)ml,much less than the open group(33.9 ±15.4)ml,the difference was statistically significant(P <0.01).The volume of drainage in the first day after operation of group endoscopy was (22.3 ±8.7)ml,less than open group(36.0 ±17.8)ml,the difference was significant(P <0.01).The postoperative stay of endoscopy group was(2 .4 ±0 .9 )d,less than open group(3.6 ±1.2)d,the difference was significant(P<0.01).The use of painkillers in endoscopy group was less than open group.The postoperative complications,time of postoperative stay and postoperative follow -up studies were both low in the two groups,and the differences were not statistically significant.Conclusion:Endoscopic thyroidectomy by trans -thoracoareolar approach is a safe and feasi-ble method.The advantages of endoscopic thyroidectomy by trans -thoracoareolar approach were less blood loss,less time of postoperative stay,less pain and no scar on the neck.