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华西医学  2014 

全乳晕入路腔镜甲状腺全切除术与开放手术治疗多发性结节性甲状腺肿的临床对照研究

DOI: 10.7507/1002-0179.20140149, PP. 499-502

Keywords: 多发性结节性甲状腺肿,甲状腺切除术,腔镜,乳晕入路

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Abstract:

目的 对比全乳晕入路腔镜甲状腺全切除术与开放手术治疗多发性结节性甲状腺肿患者的临床效果。方法 纳入2010年9月-2013年3月收治的138例需要手术治疗的双侧多发性结节性甲状腺肿患者,采用奇偶数分配的方法分为腔镜组和开放组,腔镜组(n=69)采用全乳晕入路腔镜甲状腺全切除术,开放组(n=69)采用传统开放甲状腺全切除术。观察并比较两组患者手术时间、术中出血、术中术后疼痛、术后引流、术后并发症发生情况。结果 ①腔镜组手术时间为(108.6±20.3)min,明显长于开放组(77.6±11.3)min,差异有统计学意义(t=11.084,P=0.000);腔镜组术中出血量为(28.7±9.2)mL,明显少于开放组(42.1±10.3)mL,差异有统计学意义(t=8.060,P=0.000)。②腔镜组患者术中、术后各时间点疼痛评分明显低于同期开放组患者(P<0.05)。③腔镜组、开放组术后引流量、引流时间无明显差异(P>0.05)。④两组术后暂时性低钙血症、甲状旁腺功能减退症和喉返神经损伤发生率差异无统计学意义(P>0.05),术后均未发生永久性甲状旁腺功能减退症和喉返神经损伤等严重并发症。结论 两种手术方式均可用于治疗双侧多发性结节性甲状腺肿,但腔镜手术能明显减少患者术中出血,减轻术后疼痛,且较开放手术美观。

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