经颏下三孔法腔镜甲状腺肿瘤手术的临床研究

Clinical observation of submental three-orifice endoscopic thyroid surgery

摘要:

目的 探讨经颏下三孔法腔镜甲状腺肿瘤手术的临床效果。方法 选取2021年5月－2022年6月兴安盟人民医院收治的甲状腺肿瘤患者72例，随机选择切开术式（切开组，36例）或腔镜术式（微创组，36例），对比两组患者手术资料、手术情况、术后并发症、术后术区肿胀时间、美容满意程度及疼痛评分。结果 微创组手术时间明显长于切开组，差异有统计学意义（P < 0.05）。微创组术中出血量和术后引流量明显少于切开组，拔管时间和住院时间短于切开组，差异均有统计学意义（P < 0.05）；两组患者均无声音嘶哑、低钙血症和淋巴漏等并发症发生，但微创组切口血肿发生率低于切开组，差异有统计学意义（P < 0.05）。微创组术后术区肿胀时间明显短于切开组，差异有统计学意义（P < 0.05），微创组术后3和7 d颈部疼痛评分明显低于切开组，差异有统计学意义（P < 0.05），两组患者术后1个月颈部疼痛评分比较，差异无统计学意义（P > 0.05）。微创组美容满意度评分明显高于切开组，差异有统计意义（P < 0.05）。结论 腔镜辅助下甲状腺肿瘤手术（颏下三孔法）具有微创、美容、恢复快和安全可行等特点，值得应用于临床。

Abstract:

Objective To investigate the clinical effect of submental three-orifice endoscopic thyroid surgery for thyroid tumors.Methods 72 patients with thyroid tumor from May 2021 to June 2022 were selected. According to the two treatment plans, either the incision group (36 cases) or the endoscopic group (36 cases) were randomly selected. The surgical data, surgical conditions, postoperative complications, postoperative swelling time of the operative area, aesthetic satisfaction and pain score were compared.Results The operation time of endoscopic group was significantly more than that of incision group (P < 0.05). The blood loss, drainage volume of endoscopic group were significantly less than those of incision group, extubation time and hospital stay after operation of endoscopic group were significantly shorter than those of incision group (P < 0.05). No complications such as hoarseness, hypocalcemia and lymphatic leakage occurred in the two groups, but the incidence of incision hematoma in the endoscopic group was lower than that in the incision group, and the difference was statistically significant (P < 0.05). The pain score at 3 and 7 days after surgery of endoscopic group were significantly lower than that of incision group (P < 0.05). There was no significant difference at 1 month after operation in pain score between the two groups (P > 0.05). The satisfaction scores of patients on beauty treatment of endoscopic group was significantly higher than that of incision group (P < 0.05).Conclusion Endoscopic surgery for thyroid tumors (submental three-foramen method) is minimally invasive, cosmetic, rapid recovery, safe and feasible. It is worth of clinical application.