经胸壁入路腔镜甲状腺切除术与开放手术的临床对比分析.pdf

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1、2014年1O月第7眷第5期ChinJLaparoscopicSurgery(ElectronicEdition)，October2014，Vo1．7，No．5·论著·经胸壁入路腔镜甲状腺切除术与开放手术的临床对比分析刘洪涛蔡相军刘亮王斌印慨郑成竹【摘要】目的比较完全腔镜与常规开放甲状腺切除术之间的差别，探讨腔镜下甲状腺手术的可行性和实用性。方法选择甲状腺良性肿瘤130例，随机分为经胸壁入路腔镜甲状腺切除术58例(腔镜组)和开放切除术72例(开放组)。观察比较两组手术时间、术中出血量、术后住院时间、术后引流量、引流时间、住院费用、术后美容效果、

2、术后并发症发生情况、术后疼痛评分及患者满意度等。结果开放组住院时间、切口长度显著多(长)于腔镜组(P<0．05)，出血量、手术时间、拔管时问、住院费用、引流量、术后疼痛VAS分值显著少(短)于腔镜组(P<0．05)。两组术后并发症发生率、肿瘤复发率比较，差异无统计学意义。腔镜组患者美观满意度显著高于开放组(P<0．05)。结论经胸壁入路腔镜甲状腺切除术临床效果优于开放切除术，在严格把握手术适应证的情况下是值得推崇的手术方式。【关键词】甲状腺；腔镜；胸壁入路Clinicalcomparativestudybetweenthetransthorac

3、icapproachendoscopicthyroidectomyandopensurgeryLiuHongtao，CaiXiangjun，LiuLiang，WangBin，YinKai，ZhengChengzhu．DepartmentofGeneralSurgery，The202HospitalofPeoplesLiberationArmy，Shenyang110812，ChinaCorrespondingauthor：CaiXiangjun，Email：hongtaoliu202@163．com【Abstract】0bjectiveToco

4、mparethedifferencesbetweentotalendoscopicandconventionalopenthyroidectomy．aswellasexploringthefeasibilityandefficacyofendoscopicsurgery．Methods130casesofbenignthyroidwerechosenrandomlyanddividedintotwogroups：58casesoftransthoracicendoscopicthyroidectomy(1aparoscopicgroup)and

5、72casesofopensurgery(opengroup)．Tocomparethedifferenceofoperativetime，bloodloss，postoperativehospitalstay，postoperativedrainage，drainagetime，hospitalcosts，postoperativecosmeticresuhs，postoperativecomplications，postoperativepainscoresandpatientsatisfactionintwogroups．ResultsI

6、nopengroup，hospitalstayandincisionlengthweresignificantlymore／longerthanthoseinlaparoscopicgroup(P<0．05)，bloodlossoperativetime，extubationtime，hospitalcosts，drainageandpostoperativepainVASscoreweresignificantlyless／shorterthanlaparoscopicgroup(P<0．05)．Thetwogroupshavenodiffe

7、renceintheincidenceofpostoperativecomplicationsandrecurrencerate．Patientsareverybeautifulandfull-scaleinlaparoscopicgroup，extremelyhigherthantheopengroup(P<0．05)．ConclusionUnderstrictcontrolofitsapplicability，transthoracicapproachendoscopicthyroidectomyshouldbeworthyofrecomm

8、endablesurgery，whichisbetterthanopensurgery．【Keywords】Thyroid；Endoscopic；Tr