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目的分析颈前小切口入路与改良Miccoli腔镜辅助下手术治疗甲状腺良性肿瘤的临床疗效和安全性。方法甲状腺良性肿瘤病人66例,根据手术方法的不同,将66例病人分成两组,观察组31例,行改良Miccoli腔镜辅助下手术;对照组35例,行颈前小切口入路手术。比较两组病人手术情况、美容满意度、术后6小时、12小时、24小时的视觉模拟评分(visual analogue scale,VAS)、术后并发症发生情况和声音障碍指数(voice handicap index,VHI)。结果 (1)观察组手术时间、住院时间和术中出血量分别为(44.68±23.30)分钟、(3.28±1.69)天和(43.57±23.73)m L,对照组分别为(59.43±30.61)分钟、(4.36±1.42)天和(59.43±30.61)m L,两组比较差异有统计学意义(P<0.05)。观察组和对照组的住院费用分别为(9.73±1.22)千元和(5.83±1.35)千元,两组比较差异有统计学意义(P<0.05);(2)观察组和对照组的美容满意度分别为96.8%和80.0%,两组比较差异有统计学意义(P<0.05);(3)观察组术后12小时、24小时的VAS评分分别为(3.11±0.55)分和(1.63±0.21)分,对照组分别为(4.17±0.73)分和(2.59±0.36)分,两组比较差异有统计学意义(P<0.05);(4)观察组术后并发症发生率为6.45%,对照组为11.43%;观察组术后VHI为(0.70±0.45)分,对照组为(0.65±0.39)分,两组比较差异无统计学意义(P>0.05)。结论对于甲状腺良性肿瘤病人,无论是采取改良Miccoli腔镜辅助下手术还是颈前小切口入路均安全有效,改良Miccoli腔镜辅助下手术手术时间和住院时间短、术中出血量少,美容效果好,但会增加住院费用。
Objective To analyze the clinical efficacy and safety of anterior cervical small incision approach and modified Miccoli endoscope assisted surgical treatment of thyroid benign tumors. Methods 66 patients with thyroid benign tumors were divided into two groups according to the different surgical methods. 31 patients in the observation group underwent modified Miccoli endoscope-assisted surgery; 35 patients in the control group underwent anterior small neck incision. The visual analogue scale (VAS), postoperative complications, and voice handicap index (VHI) were compared between the two groups of patients’ surgical conditions, cosmetic satisfaction, 6 hours, 12 hours, and 24 hours after operation. . Results (1) The operative time, length of hospital stay, and intraoperative blood loss in the observation group were (44.68±23.30) minutes, (3.28±1.69) days, and (43.57±23.73) m L, respectively, and in the control group were (59.43±30.61) minutes. There were significant differences between the two groups (4.36±1.42 days and (59.43±30.61) m L) (P<0.05). The hospitalization costs of the observation group and the control group were (9.73±1.22) thousand yuan and (5.83±1.35) thousand yuan respectively, there was a statistically significant difference between the two groups (P<0.05); (2) the beauty of the observation group and the control group Satisfaction was 96.8% and 80.0%, respectively. There was a statistically significant difference between the two groups (P<0.05). (3) The VAS scores of the observation group at 12 hours and 24 hours were (3.11±0.55) points and (1.63) respectively. ±0.21) points in the control group were (4.17±0.73) points and (2.59±0.36) points, there was a statistically significant difference between the two groups (P<0.05); (4) The postoperative complication rate in the observation group was 6.45 %, the control group was 11.43%; the postoperative VHI was (0.70±0.45) points in the observation group and (0.65±0.39) points in the control group, there was no significant difference between the two groups (P>0.05). Conclusion For patients with thyroid benign tumors, whether the use of modified Miccoli endoscope-assisted surgery or small incision before the neck approach is safe and effective, improved Miccoli endoscope-assisted surgery time and hospital stay is shorter, less intraoperative blood loss, cosmetic results Yes, but it will increase the cost of hospitalization.