经胸乳入路腔镜甲状腺手术与常规开放手术治疗甲状腺腺瘤患者的观察
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摘要
目的研究经胸乳入路腔镜甲状腺手术与常规开放手术治疗甲状腺腺瘤患者的临床效果。方法选取2016年6月～2018年2月本院116例甲状腺腺瘤患者,按照随机数字表法分为腔镜组(n=58)和常规组(n=58)。常规组采用常规开放手术治疗,腔镜组采用经胸乳入路腔镜甲状腺手术治疗。对比两组手术时长、术中失血量、术后引流量、术后住院时长,并比较两组术后疼痛程度(VAS评分)、抑郁程度(HAMD评分)、焦虑程度(HAMA评分)及并发症发生情况。结果腔镜组术中失血量、术后住院时长少于常规组,手术时长长于常规组,术后引流量多于常规组,差异有统计学意义(P <0.05);手术后1d、3d,腔镜组VAS评分低于常规组,差异有统计学意义(P <0.05);手术后3d两组HAMD及HAMA评分均低于手术前,且腔镜组低于常规组,差异有统计学意义(P <0.05);腔镜组并发症总发生率低于常规组,差异有统计学意义(P <0.05)。结论与常规开放手术相比,经胸乳入路腔镜甲状腺手术治疗甲状腺腺瘤能显著减少术中出血量,促进患者康复,且术后疼痛程度及焦虑、抑郁程度更低,安全可靠。
Objective To explore the clinical effects of transthoracic laparoscopic thyroid surgery and conventional open surgery for thyroid adenoma. Methods 116 patients with thyroid adenoma from June 2016 to February 2018 were enrolled.The patients were divided into laparoscopic group(n=58) and conventional group(n=58) according to the random number table method. The conventional group was treated with conventional open surgery, and the laparoscopic group was treated with transthoracic laparoscopic thyroid surgery. The duration of surgery, intraoperative blood loss, postoperative drainage,postoperative hospitalization, and postoperative pain(VAS score), depression(HAMD score), anxiety(HAMA score), and complications were compared between the two groups. Results The blood loss and length of postoperative hospitalization in the laparoscopic group were less than those in the conventional group. The duration of surgery was longer than that in the conventional group. The postoperative drainage was more than that in the conventional group(P < 0.05). 1 d and 3 d after surgery, The VAS score of the laparoscopic group was lower than that of the conventional group(P < 0.05). The HAMD and HAMA scores of the two groups were lower than that before the operation, and the laparoscopic group was lower than the conventional group. The differences were statistically significant(P < 0.05); the total incidence of complications in the laparoscopic group was lower than that in the conventional group, and the difference was statistically significant(P < 0.05).Conclusion Compared with conventional open surgery, transthoracic thyroid surgery for thyroid adenoma can significantly reduce the amount of intraoperative blood loss, promote the recovery of patients, and the degree of postoperative pain, anxiety and depression are lower, which is safe and reliable.
Objective To explore the clinical effects of transthoracic laparoscopic thyroid surgery and conventional open surgery for thyroid adenoma. Methods 116 patients with thyroid adenoma from June 2016 to February 2018 were enrolled.The patients were divided into laparoscopic group(n=58) and conventional group(n=58) according to the random number table method. The conventional group was treated with conventional open surgery, and the laparoscopic group was treated with transthoracic laparoscopic thyroid surgery. The duration of surgery, intraoperative blood loss, postoperative drainage,postoperative hospitalization, and postoperative pain(VAS score), depression(HAMD score), anxiety(HAMA score), and complications were compared between the two groups. Results The blood loss and length of postoperative hospitalization in the laparoscopic group were less than those in the conventional group. The duration of surgery was longer than that in the conventional group. The postoperative drainage was more than that in the conventional group(P < 0.05). 1 d and 3 d after surgery, The VAS score of the laparoscopic group was lower than that of the conventional group(P < 0.05). The HAMD and HAMA scores of the two groups were lower than that before the operation, and the laparoscopic group was lower than the conventional group. The differences were statistically significant(P < 0.05); the total incidence of complications in the laparoscopic group was lower than that in the conventional group, and the difference was statistically significant(P < 0.05).Conclusion Compared with conventional open surgery, transthoracic thyroid surgery for thyroid adenoma can significantly reduce the amount of intraoperative blood loss, promote the recovery of patients, and the degree of postoperative pain, anxiety and depression are lower, which is safe and reliable.
引文
[1]张轶,李正凯,李洪涛,等.经胸乳入路腔镜甲状腺手术与传统甲状腺手术的疗效对比[J].现代肿瘤医学,2015,23(24):3585-3588.
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[5]麦建全,杨景先,林帆,等.经乳晕入路腔镜甲状腺切除术的临床应用[J].中国现代手术学杂志,2015,19(1):28-30.
[6]夏非,谭华章.经胸乳入路腔镜甲状腺手术治疗甲状腺腺瘤的疗效分析[J].河北医药,2017,39(17):2670-2672.
[2]谭卓,郑传铭,葛明华,等.经胸乳入路腔镜甲状腺手术的临床应用效果[J].中国现代医生,2016,54(13):55-58.
[3]周鸣,刘溦薇,顾懿帆,等.420例经胸乳入路全腔镜下甲状腺手术体会[J].中国普外基础与临床杂志,2016,23(5):569-572.
[4]傅锦波,罗晔哲,洪晓泉,等.经腋窝入路与经胸乳入路腔镜甲状腺切除术的对比研究[J].中国微创外科杂志,2017,17(8):688-690.
[5]麦建全,杨景先,林帆,等.经乳晕入路腔镜甲状腺切除术的临床应用[J].中国现代手术学杂志,2015,19(1):28-30.
[6]夏非,谭华章.经胸乳入路腔镜甲状腺手术治疗甲状腺腺瘤的疗效分析[J].河北医药,2017,39(17):2670-2672.