经口腔裸眼3D腔镜甲状腺切除的效果评价

发布时间：2018-03-24 19:54

本文选题：裸眼D　切入点：腔镜甲状腺切除　出处：《暨南大学学报(自然科学与医学版)》2017年01期

【摘要】：目的:评价裸眼3D腔镜甲状腺手术的安全性和疗效.方法:按制定的纳入和排除标准,纳入2015年4月至2016年12月间接受完全经口腔前庭3D腔镜甲状腺切除术的患者14名,其中偏光3D系统手术组患者8名,采用裸眼3D系统手术组患者6名,回顾比较两组患者的临床结局,以及手术医生的操作感受;患者随访1~6个月.结果:偏光3D腔镜手术组平均年龄(43.13±15.69)岁,BMI(24.49±3.42)kg/m2,裸眼3D系统手术组平均年龄(37.83±8.80)岁,BMI(20.97±2.36)kg/m2,两组比较无显著差异.偏光3D手术组的平均手术时间(218.30±46.30)min,术中失血量为(10.43±4.96)m L,术后平均住院天数为(4.50±0.54)d;裸眼3D手术组平均手术时间为(203.83±58.40)min,术中失血量为(12.12±5.99)m L,术后平均住院天数为(4.63±1.48)d;两组比较,均无统计学差异,两组患者均无围手术期并发症;术后6 h可进食凉全流,术后第1天即可恢复正常饮食;所有患者对手术效果和外观满意.裸眼3D系统能明显降低手术者的眼疲劳,手术医生主观评价使用裸眼3D系统的眼疲劳评分(3.67±0.52)明显低于使用偏光3D系统的眼疲劳评分(7.00±0.76)(P0.05).腔镜下画面和非腔镜下操作的转换的视觉感受良好,符合2D操作的操作感受,画面的色彩饱和度和亮度优于偏光3D系统.但由于目前的裸眼3D系统仅能对术者实施裸眼,助手的感受没有得到相应的改善.结论:在完全经口腔前庭入路腔镜甲状腺手术中,裸眼3D显像腔镜手术系统的疗效与安全性与常规偏光3D显像腔镜系统相当,并能明显降低术者的眼疲劳,维持良好的画面色彩饱和度和亮度,并可潜在提高手术效率.
[Abstract]:Objective: to evaluate the safety and efficacy of 3D endoscopic thyroidectomy with naked eyes. Methods: according to the criteria of inclusion and exclusion, 14 patients who were indirectly underwent 3D thyroidectomy through oral vestibule from April 2015 to December 2016 were included in this study. There were 8 patients in the polarizing 3D system operation group and 6 patients in the naked eye 3D system group. The clinical outcomes of the two groups were retrospectively compared, as well as the operating experience of the surgeon. Results: the mean age was 43.13 卤15.69 years old and the mean age was 24.49 卤3.42 kg 路m ~ (-2) in the 3D surgery group and 20.97 卤2.36 kg / m ~ (2) in the naked eye 3D system group respectively. There was no significant difference between the two groups. The mean operative time was 218.30 卤46.30 min in the polarizing 3D operation group and 20.83 卤8.80 years old in the naked eye 3D system group, and the mean operative time was 218.30 卤46.30 min. The average postoperative hospitalization time was 4.50 卤0.54 / d, the mean operative time was 203.83 卤58.40 min, the intraoperative blood loss was 12.12 卤5.99mL, and the average postoperative hospital stay was 4.63 卤1.48mL in the naked eye 3D operation group, and the mean postoperative hospitalization time was 4.63 卤1.48mL, the mean postoperative hospitalization time was 4.63 卤1.48mL, the mean operative time was 203.83 卤58.40 min, and the mean postoperative blood loss was 12.12 卤5.99mL, respectively. There was no statistical difference between the two groups, there were no perioperative complications in the two groups, the patients in the two groups could eat cool whole stream at 6 hours after operation, and the normal diet could be restored on the first day after operation. All the patients were satisfied with the effect and appearance of the operation. The subjective evaluation by the surgeon was that the eye fatigue score using the naked eye 3D system was 3.67 卤0.52significantly lower than that with the polarizing 3D system (7.00 卤0.76) P0.05. The visual perception of the conversion between the image under the mirror and the non-endoscopic operation was good, which was in line with the operational feeling of 2D operation. The color saturation and brightness of the image are superior to that of the polarizing 3D system. However, because the current naked 3D system can only be applied to the naked eye, the assistant's feeling has not been improved. Conclusion: in the endoscopic thyroidectomy through the oral vestibule approach, The efficacy and safety of the endoscopic surgery system of naked eye 3D imaging is similar to that of the conventional polarizing 3D imaging system, and it can obviously reduce the fatigue of the eyes, maintain good color saturation and brightness, and potentially improve the efficiency of the operation.
【作者单位】：广州医科大学附属第一医院胃肠外科;广州医科大学附属第一医院口腔科;
【基金】：广东省科技计划项目(2014A020212610) 广东省医学科学技术研究基金项目(A2015515)
【分类号】：R653

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