经胸乳晕腔镜甲状腺手术的临床应用及学习曲线研究

发布时间：2018-03-24 02:00

本文选题：甲状腺手术　切入点：腔镜手术　出处：《实用医学杂志》2017年15期

【摘要】：目的探讨经胸乳晕腔镜甲状腺手术治疗甲状腺良性结节的临床效果及学习曲线。方法自2012年1月至2016年5月,首都医科大学宣武医院普外科开展经胸乳晕腔镜甲状腺手术,对49例患者临床特征、预后及手术时间进行回顾分析,依手术次序将患者分为9组,采用移动平均线法分析学习曲线。结果成功完成49例经胸乳晕腔镜甲状腺手术,结节平均大小(2.80±0.62)cm,其中10例行双侧甲状腺手术,39例行单侧甲状腺手术。平均手术时间(157.49±21.23)min,2例因术后病理为恶性行二次手术。所有患者术后均未发生喉返神经损伤,11例患者术后出现无症状低钙血症但甲状旁腺素正常。患者对术后美容效果均满意。学习曲线提示完成早期学习阶段,需完成35例腔镜甲状腺手术。结论对具备常规甲状腺手术经验的外科医生选择合适的患者实行经胸乳晕腔镜甲状腺手术是安全可行的。开展腔镜甲状腺手术存在显著的学习曲线,初学者早期学习阶段需完成35例腔镜甲状腺手术。
[Abstract]:Objective to investigate the clinical effect and learning curve of breast areola of endoscopic thyroidectomy for benign thyroid nodules. Methods from January 2012 to May 2016, Xuanwu Hospital of Capital Medical University, Department of general surgery of transthoracic endoscopic thyroid surgery on the areola, 49 cases of patients with clinical features, and pre operation time were retrospectively analyzed, according to the order of the surgical patients were divided into 9 groups, using the the moving average method to analyze the learning curve. The results of 49 cases breast areola endoscopic thyroid surgery successfully completed, the average size of nodules (2.80 + 0.62) cm, of which 10 cases underwent bilateral thyroidectomy, 39 patients underwent unilateral thyroid surgery. The average operation time (157.49 + 21.23) min, 2 cases with postoperative pathology malignant two surgery for all the patients. There was no recurrent laryngeal nerve injury, 11 cases of patients with asymptomatic hypocalcemia but normal parathyroid hormone. Patients of postoperative cosmetic effect Satisfied. The learning curve prompts to complete the early learning stage, completed 35 cases of endoscopic thyroid surgery. Conclusion the choice of conventional thyroid surgery experience of the surgeon implement appropriate patients transthoracic areola endoscopic thyroidectomy is safe and feasible. To carry out endoscopic thyroid surgery in a significant learning curve, beginners need to complete 35 cases of early stage laparoscopic thyroidectomy the operation.

【作者单位】：首都医科大学宣武医院普外科;
【基金】：北京市卫生系统高层次卫生技术人才培养计划项目资助(编号:2011-2-28) 2011年度高等学校博士学科点专项科研基金资助项目(编号:20111107110001)
【分类号】：R653

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