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目的探讨经胸乳途径腔镜甲状腺手术治疗的安全性和可行性。方法回顾性分析北京世纪坛医院2005年12月至2009年10月收治的275例甲状腺良性肿瘤的临床资料。结果腔镜手术124例(腔镜组),开放手术151例(开放组),两组手术的切口引流量、术后对镇痛的需求、术后住院时间差异无统计学意义。腔镜组术中出血量[(24.52±9.87)mL]明显少于开放组[(39.67±25.88)mL],差异有统计学意义(P<0.05);但腔镜组手术时间[(127.66±34.83)min]长于开放组[(95.17±29.86)min],P<0.05;腔镜组住院费用显著高于开放组。腔镜组对手术美容效果满意度评分(8.94±0.81)明显高于开放组(5.74±1.61)(P<0.05)。两组均无术后大出血及喉返喉上神经损伤和甲状旁腺损伤等严重并发症。结论腔镜甲状腺手术具有切口小、出血少、美容满意度高等优点,是安全可行的手术方法。
Objective To investigate the safety and feasibility of endoscopic thyroidectomy via transthoracic approach. Methods The clinical data of 275 cases of thyroid benign tumors treated in Beijing Shitanatitan Hospital from December 2005 to October 2009 were retrospectively analyzed. Results 124 cases of endoscopic surgery (endoscopic group), 151 cases of open surgery (open group), two groups of surgical incision drainage, postoperative analgesic demand, postoperative hospital stay was no significant difference. The amount of bleeding in the endoscopic group was significantly lower than that in the open group [(24.52 ± 9.87) mL vs (39.67 ± 25.88) mL, P <0.05) 34.83) min] was longer than that of the open group [(95.17 ± 29.86) min], P <0.05; the cost of the laparoscopic group was significantly higher than that of the open group. The score of satisfaction of surgical cosmetic results of endoscopic group (8.94 ± 0.81) was significantly higher than that of open group (5.74 ± 1.61) (P <0.05). No severe complications were found in the two groups, including postoperative hemorrhage, upper nerve laryngeal laryngeal and parathyroid injury. Conclusions Endoscopic thyroidectomy has the advantages of small incision, less bleeding, higher cosmetic satisfaction, and is a safe and feasible surgical method.