腔镜甲状腺切除术与开放甲状腺切除术治疗良性甲状腺疾病疗效比较

摘要

目的 比较腔镜甲状腺切除术与开放甲状腺切除术治疗良性甲状腺疾病的临床效果.方法 选择2015年3月至2017年6月新乡医学院第三附属医院收治的良性甲状腺疾病患者120例为研究对象,根据治疗方法分为腔镜手术组(n=62)和开放手术组(n=58),开放手术组患者给予传统的开放甲状腺切除术,腔镜手术组患者给予腔镜甲状腺切除术.记录2组患者手术时间、术中出血量、术后引流量及住院时间,并观察患者术中及术后并发症.术后6、12、24 h采用视觉模拟评分法(VAS)对2组患者疼痛程度进行评分,术后1、3个月采用数字评分系统(NSS)对2组患者美容满意度进行评分.结果 腔镜手术组患者手术时间和住院时间显著短于开放手术组(P<0.05),术中出血量、术后引流量显著少于开放手术组(P<0.05).腔镜手术组患者术后6、12、24 h VAS评分显著低于开放手术组(P<0.05),腔镜手术组患者术后1、3个月NSS评分显著高于开放手术组(P<0.05).腔镜手术组和开放手术组并发症发生率分别为12.90％(8/62)、39.66％(23/58),腔镜手术组患者并发症发生率显著低于开放手术组(χ2=11.210,P<0.05).结论 腔镜甲状腺切除术治疗良性甲状腺疾病疗效可靠,且具有创伤小、手术时间短、术后恢复快、术后疼痛轻、手术瘢痕小、并发症少等优点.%Objective To compare the clinical effect of endoscopic thyroidectomy and open thyroidectomy in the treat-ment of benign thyroid diseases. Methods A total of 120 patients with benign thyroid diseases were selected from March 2015 to June 2017 in the Third Affiliated Hospital of Xinxiang Medical University. The patients were divided into endoscopic opera-tion group(n = 62)and open operation group(n = 58)according to the treatment methods. The patients in the open operation group were treated with conventional open thyroidectomy,and the patients in the endoscopic operation group were treated with endoscopic thyroidectomy. The operation time,intraoperative bleeding volume,postoperative drainage volume and hospitalization time were recorded in the two groups;and the intraoperative and postoperative complications were observed. The pain of the pa-tients in the two groups was evaluated by visual analogue scale(VAS)at the time points of 6,12 and 24 hours after operation. The cosmetic satisfaction of the patients in the two groups was evaluated by numerical scoring system(NSS)at the time points of 1 and 3 months after operation. Results The operation time and hospitalization time in the endoscopic operation group were significantly shorter than those in the open operation group(P < 0. 05),and the intraoperative bleeding volume and postopera-tive drainage volume in the endoscopic operation group were significantly lower than those in the open operation group(P <0. 05). The VAS score of pain in the endoscopic operation group was significantly lower than that in the open operation group at the time points of 6,12 and 24 hours after operation(P < 0. 05). The NSS score in the endoscopic operation group was sig-nificantly higher than that in the open operation group at the time points of 1 and 3 months after operation(P < 0. 05). The in-cidence of complications in the endoscopic operation group and the open operation group was 12. 90％(8 / 62)and 39. 66％(23 / 58)respectively,the incidence of complications in the endoscopic operation group was significantly lower than that in the open operation group(χ2 = 11. 210,P < 0. 05). Conclusion Endoscopic thyroidectomy is reliable in the treatment of benign thyroid diseases. It has the advantages of small trauma,short operation time,quick recovery,light postoperative pain,small sur-gical scar and fewer complications and so on.