胸乳路径腔镜甲状腺手术与传统开放甲状腺手术的对比研究

发布时间：2018-01-31 15:30

本文关键词： 甲状腺结节甲状腺切除术内窥镜检查胸乳路径开放手术　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:对比研究胸乳路径腔镜甲状腺手术与传统开放甲状腺手术的临床效果,探讨胸乳路径腔镜甲状腺手术的临床疗效及其价值。方法:对浙江省丽水市中心医院2014年12月至2016年11月收治的甲状腺良性结节患者共93例的临床数据进行回顾性研究分析,其中行胸乳路径腔镜甲状腺手术的患者45例(腔镜组),48例患者行传统的颈部切口甲状腺手术(开放组),比较两组的手术时间、术中出血量、术后引流管引流量、引流管拔除的时间、术后住院院时间、切口总长度、术后疼痛评分、术后相关并发症、切口满意度等情况。结果:两组患者手术均顺利完成,均由一位主刀医生顺利完成,腔镜组无中途转向开放手术。腔镜组与开放组手术时间比较有统计学差异[(122.53±33.17)min vs(99.40±11.60)min,t=4.55,P=0.00],术中出血量两组对比有统计学差异[(34.69±9.84)ml vs(43.77±11.50)ml,t=4.08,P=0.00],术后引流管引流液量两组比较有统计学差异[(101.67±25.22)ml vs(66.35±11.82)ml,t=8.73,P=0.00],术后疼痛评分[(2.93±0.80)vs(3.94±0.99),t=5.40,P=0.00]、切口总长度[(3.33±0.17)cm vs(6.69±0.97)cm,t=22.76,P=0.00]与切口满意程度(Z=8.63,P=0.00)两组比较均提示有统计学差异,而引流管拔除时间[(75.64±11.98)h vs(73.33±11.13)h,t=0.97,P=0.34]和术后住院时间[(80.67±13.33)h vs(81.73±11.78)h,t=0.22,P=0.68]与术后总并发症(χ2=2.35,P=0.13)两组比较均无统计学差异。结论:经胸乳路径腔镜甲状腺手术虽较传统开放甲状腺手术手术时间长,术后液体引流多,但其手术失血少,患者疼痛程度低,切口长度短,患者满意度高,且术后并发症两组无差异,是一种临床疗效佳兼并较好美容效果的甲状腺手术方式。
[Abstract]:Objective: to compare the clinical effects of endoscopic thyroidectomy with traditional open thyroid surgery. To investigate the clinical effect and value of sternomammary path endoscopic thyroidectomy. The clinical data of 93 patients with benign thyroid nodules admitted from December 2014 to November 2016 in Lishui City Central Hospital of Zhejiang Province were analyzed retrospectively. Among them, 45 patients underwent endoscopic thyroidectomy via breast and breast pathway (48 patients in the endoscopic group) underwent traditional cervical incision thyroid surgery (open group, the operative time and the amount of blood lost during operation were compared between the two groups. Postoperative drainage flow, drainage tube extraction time, postoperative hospital time, total incision length, postoperative pain score, postoperative complications. Results: the two groups of patients were successfully completed by a surgeon, the endoscopic group did not turn to open surgery midway. There was a statistical difference between the endoscopic group and the open group. [122.53 卤33.17 vs(99.40 卤11.60 min vs(99.40 卤4.55% P0. 00. There was a statistical difference between the two groups in blood loss during operation. [The volume of drainage fluid in the two groups was significantly higher than that in the control group (34.69 卤9.84ml vs(43.77 卤11.50ml vs(43.77 卤11.50ml). [101.67 卤25.22ml / vs(66.35 卤11.82ml / ml / vs(66.35 卤11.82ml / ml / vs(66.35 卤11.82ml / ml / vs(66.35 卤11.82ml / ml / vs(66.35 卤11.82ml / ml / vs(66.35 卤11.8@@. [2. 93 卤0. 80 VSD 3.94 卤0. 99 t 5. 40 P0. 00], total incision length (2. 93 卤0. 80) and total incision length (3. 94 卤0. 99). [3. 33 卤0. 17cm vs(6.69 卤0. 97 vs(6.69 卤22. 76cm P0. 00] and the degree of satisfaction of the incision was 8. 63% (P < 0. 05). P0. 00.) the comparison between the two groups indicates that there is a statistical difference, and the drainage tube unplug time. [75.64 卤11.98 h vs(73.33 卤11.13 h vs(73.33 0.97 h and postoperative hospitalization time. [80.67 卤13.33 vs(81.73 卤11.78 h vs(81.73 0.22 ~ 0.68 and total postoperative complications (蠂 ~ 2 卤2.35). Conclusion: the transthoracic and mammary approach endoscopic thyroid surgery is longer than the traditional open thyroid surgery, more fluid drainage, but less blood loss. Patients with low pain, short incision length, high patient satisfaction, and there is no difference in postoperative complications between the two groups, is a good clinical effect with good cosmetic effect of thyroid surgery.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R653

【相似文献】