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目的:探讨改良中上入路甲状腺癌根治术对早期甲状腺癌患者颈胸部疼痛、美容效果及术后生命质量的影响。方法:选取2017年1月至2020年1月河北省秦皇岛市第三医院早期甲状腺癌患者97例，按随机数字表法分为对照组（行传统外侧入路甲状腺癌根治术，48例）和观察组（行改良中上入路甲状腺癌根治术，49例）。比较两组手术情况（手术时间、术中出血量、淋巴结清扫数目、引流时间、引流量和住院时间）、手术并发症；采用视觉模拟评分（VAS）评估术后1 d、3 d、1个月和3个月颈部和胸部疼痛程度；术后3个月采用温哥华瘢痕量表评估切口美容效果；术前及术后3、6个月采用汉化甲状腺癌特异性生命质量（THYCA-QoL）量表评估患者生命质量。结果:两组淋巴结清扫数目、引流量和住院时间比较差异无统计学意义（n P>0.05）；观察组手术时间、术中出血量和引流时间均明显少于对照组[（116.57 ± 25.75）min比（129.87 ± 30.01）min、（31.25 ± 4.15）ml比（37.98 ± 6.34）ml和（2.57 ± 0.45）d比（3.32 ± 0.67）d]，差异有统计学意义（n P<0.05或<0.01）。观察组总并发症发生率明显低于对照组[8.16%（4/49）比45.83%（22/48）]，差异有统计学意义（n χ2 = 15.324，n P<0.01）。观察组术后1 d、3 d、1个月颈部VAS和术后3 d、1个月胸部VAS均明显低于对照组，差异有统计学意义（n P<0.01或0.05）。观察组术后3个月温哥华瘢痕量表评分明显低于对照组[（6.15 ± 1.35）分比（8.43 ± 2.17）分]，差异有统计学意义（n P<0.01）；观察组术后3和6个月THYCA-QoL评分明显高于对照组[（46.25 ± 9.87）分比（40.14 ± 7.52）分和（53.65 ± 15.14）分比（46.58 ± 9.87）分]，差异有统计学意义（n P0.05); the operation time, intraoperative blood loss and drainage time in observation group were significantly lower than those in control group: (116.57 ± 25.75) min vs. (129.87 ± 30.01) min, (31.25 ± 4.15) ml vs. (37.98 ± 6.34) ml and (2.57 ± 0.45) d vs. (3.32 ± 0.67) d, and there were statistical differences (n P<0.05 or <0.01). The total complication incidence in observation group was significantly lower than that in control group: 8.16% (4/49) vs. 45.83% (22/48), and there was statistical difference (n χ2 = 15.324, n P<0.01). Neck VAS 1 d, 3 d and 1 month after surgery and chest VAS 3 d and 1 month after surgery in observation group were significantly lower than those in control group, and there were statistical differences (n P<0.01 or 0.05). The Vancouver scar scale score 3 months after surgery in observation group was significantly lower than that in control group: (6.15 ± 1.35) scores vs. (8.43 ± 2.17) scores, and there was statistical difference (n P<0.01). The THYCA-QoL score 3 and 6 months after surgery in observation group were significantly higher than that in control group: (46.25 ± 9.87) scores vs. (40.14 ± 7.52) scores and (53.65 ± 15.14) scores vs. (46.58 ± 9.87) scores, and there was statistical difference (n P<0.01).n Conclusions:Compared with the traditional lateral approach, the modified middle and upper approach radical resection of thyroid carcinoma in treatment of early thyroid carcinoma can shorten the operation time, reduce intraoperative blood loss, reduce the incidence of surgical complications and reduce early postoperative neck and chest pain. It has better cosmetic effects and improves the quality of life of the patients.