全腔镜或腔镜辅助下甲状腺次全切除术疗效和安全性评价
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摘要
目的将全腔镜或腔镜辅助下甲状腺次全切除术运用于甲状腺疾病患者中,评价临床疗效以及安全性。方法该文纳入研究的资料是方便选取2016年5月—2018年4月在该医院接受甲状腺次全切除术治疗的70例甲状腺疾病患者,分组法采取硬币法,一组纳入35例,传统甲状腺次全切除术用于对照组,全腔镜或腔镜辅助下甲状腺次全切除术用于试验组,计算并分析两组患者的手术用时、术中出血量、术后引流管留置天数、术后切口引流量、术后并发症总统计率。结果试验组患者的手术用时(75.12±6.80)min相比于对照组患者对应指标(73.50±6.87)min(t=0.991,P>0.05),试验组患者的术中出血量(26.70±2.14)mL相比于对照组患者对应指标(32.24±3.20)mL更低,(t=8.513,P<0.05),试验组患者的术后引流管留置天数(3.39±2.05)d相比于对照组患者对应指标(4.30±2.11)d(t=1.830,P>0.05),试验组患者的术后切口引流量(57.10±4.12)mL相比于对照组患者对应指标(59.51±4.30)mL更低(t=2.394,P<0.05),试验组患者的术后并发症总统计率(2.86%)相比于对照组患者对应指标(17.14%)更低(χ~2=3.968 3,P<0.05)。结论对甲状腺疾病患者采取全腔镜或腔镜辅助下甲状腺次全切除术展示较优临床疗效,并发症少,存在安全性。
Objective To evaluate the clinical curative effect and safety of subtotal thyroidectomy assisted by total endoscopy and endoscopy.Methods 70 cases of patients with thyroid diseases treated with subtotal thyroidectomy in our hospital from May 2016 to April 2018 were convenient selected and randomly divided into two groups with 35 cases in each,the control group used the traditional subtotal thyroidectomy,while the test group were treated with subtotal thyroidectomy assisted by total endoscopy and endoscopy,and the operation time,intraoperative bleeding amount,postoperative tube indwelling day,postoperative incision drainage amount and total statistics rate of total complications after surgery were calculated and analyzed.Results The operation time in the test group and in the control group was respectively(75.12±6.80)min and(73.50±6.87)min(t=0.991,P>0.05),and the intraoperative bleeding amount in the test group was lower than that in the control group[(26.70±2.14)mL vs(32.24±3.20)mL(t=8.513,P<0.05)],and the postoperative tube indwelling day in the test group and in the control group was respectively(3.39±2.05)d and(4.30±2.11)d(t=1.830,P>0.05) and the postoperative incision drainage amount in the test group was lower than that in the control group[(57.10±4.12)mL vs(59.51±4.30)mL(t=2.394,P<0.05)],and the total statistics rate of postoperative complications in the test group was lower than that in the control group(2.86% vs 17.14%)(χ~2=3.968 3,P<0.05).Conclusion The clinical curative effect of subtotal thyroidectomy assisted by total endoscopy and endoscopy of patients with thyroids is better with few complications,and safety.
Objective To evaluate the clinical curative effect and safety of subtotal thyroidectomy assisted by total endoscopy and endoscopy.Methods 70 cases of patients with thyroid diseases treated with subtotal thyroidectomy in our hospital from May 2016 to April 2018 were convenient selected and randomly divided into two groups with 35 cases in each,the control group used the traditional subtotal thyroidectomy,while the test group were treated with subtotal thyroidectomy assisted by total endoscopy and endoscopy,and the operation time,intraoperative bleeding amount,postoperative tube indwelling day,postoperative incision drainage amount and total statistics rate of total complications after surgery were calculated and analyzed.Results The operation time in the test group and in the control group was respectively(75.12±6.80)min and(73.50±6.87)min(t=0.991,P>0.05),and the intraoperative bleeding amount in the test group was lower than that in the control group[(26.70±2.14)mL vs(32.24±3.20)mL(t=8.513,P<0.05)],and the postoperative tube indwelling day in the test group and in the control group was respectively(3.39±2.05)d and(4.30±2.11)d(t=1.830,P>0.05) and the postoperative incision drainage amount in the test group was lower than that in the control group[(57.10±4.12)mL vs(59.51±4.30)mL(t=2.394,P<0.05)],and the total statistics rate of postoperative complications in the test group was lower than that in the control group(2.86% vs 17.14%)(χ~2=3.968 3,P<0.05).Conclusion The clinical curative effect of subtotal thyroidectomy assisted by total endoscopy and endoscopy of patients with thyroids is better with few complications,and safety.
引文
[1]崔勇,孙茂伟,赵东旭,等.甲状腺全切除术在分化型甲状腺癌外科治疗中的应用价值[J].实用癌症杂志,2017,32(7)1214-1215.
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[6]严恺舒,廖锡强,赵崇汉,等.喉罩辅助下SIMV模式全麻在老年人甲状腺次全切除术中的研究[J].中国当代医药,2018,25(5):107-109.
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[8]王勇,孙毅群,杨玉,等.甲状腺次全切除术术后感染相关因素分析[J].中华医院感染学杂志,2017,27(9):2032-2034,2042.
[9]Merchavy Shlomo,Marom Tal,Forest Veronique-Isabelle,et al.Comparison of the Incidence of Postoperative Hypocalcemia following Total Thyroidectomy vs Completion Thyroidectomy[J].Otolaryngology--head and neck surgery:official journal of American Academy of Otolaryngology-Head and Neck Surgery,2015,152(1):53-56.
[10]梅亮.3D腹腔镜经胸乳入路甲状腺次全切除术疗效和安全性分析[J].临床普外科电子杂志,2017,5(1):9-12.
[2]金海龙,周予民,潘炯,等.甲状腺下动脉结扎方式对甲状腺次全切除术后甲状旁腺功能的影响[J].疑难病杂志,201615(4):378-380,385.
[3]Lang Brian Hung-Hin,Wong Carlos K H,Tsang,Julian S,e al.A Systematic Review and Meta-analysis Evaluating Completeness and Outcomes of Robotic Thyroidectomy[J].The Laryngoscope:A Medical Journal for Clinical and Research Contributions in Otolaryngology,Head and Neck Medicine and Surgery,Facial Plastic and Reconstructive Surgery,2015,125(2):509-518.
[4]马瑞丽.甲状腺次全切除术中预防喉返神经损伤的处理[J].中国实用神经疾病杂志,2017,20(15):107-108.
[5]曾文晓.甲状腺全切术和甲状腺次全切术治疗双侧结节性甲状腺肿的疗效对比分析[J].黑龙江医药,2016,29(2):308-310.
[6]严恺舒,廖锡强,赵崇汉,等.喉罩辅助下SIMV模式全麻在老年人甲状腺次全切除术中的研究[J].中国当代医药,2018,25(5):107-109.
[7]Chun Byung-Joon,Bae Ja-Sung,Chae Byung-Joo,et al.The therapeutic decision making of the unilateral vocal cord palsy after thyroidectomy using thyroidectomy-related voice questionnaire(TVQ)[J].European archives of oto-rhinolaryngology:Official journal of the European Federation of Oto-Rhino-Laryngological Societies(EUFOS),2015,272(3):727-736.
[8]王勇,孙毅群,杨玉,等.甲状腺次全切除术术后感染相关因素分析[J].中华医院感染学杂志,2017,27(9):2032-2034,2042.
[9]Merchavy Shlomo,Marom Tal,Forest Veronique-Isabelle,et al.Comparison of the Incidence of Postoperative Hypocalcemia following Total Thyroidectomy vs Completion Thyroidectomy[J].Otolaryngology--head and neck surgery:official journal of American Academy of Otolaryngology-Head and Neck Surgery,2015,152(1):53-56.
[10]梅亮.3D腹腔镜经胸乳入路甲状腺次全切除术疗效和安全性分析[J].临床普外科电子杂志,2017,5(1):9-12.