刘宇飞　潘兴艳　肖爱霞

[摘要] 目的 探討甲状腺良性肿瘤患者行腔镜甲状腺良性肿瘤摘除术的治疗及效果。 方法 选择2016年1月～2017年2月在我院住院的60例甲状腺良性肿瘤患者作为研究对象。入院后行常规腔镜甲状腺肿瘤切除（观察组）与开放甲状腺肿瘤切除（对照组），由患者决定手术方式。将两组患者的手术时间、术中出血量、切口引流量、术后镇痛需求、住院时间、住院费用、美容满意度进行比较。 结果 观察组的美容满意度高于对照组（P<0.05）；观察组的手术时间、术中出血量、切口引流量、住院时间、住院费用优于对照组（P<0.05）；干预前两组生存质量相近（P>0.05）；干预后观察组生存质量优于对照组（P<0.05）。观察组术后镇痛需求少于对照组（P<0.05）。 结论 甲状腺良性肿瘤患者行腔镜甲状腺良性肿瘤摘除术的治疗及效果确切，可有效切除病变，减少术后镇痛需求，改善生存质量，缩短手术和住院时间，减少医疗费用，减少出血量。

[关键词] 甲状腺良性肿瘤；腔镜；出血量；生存质量

[中图分类号] R736.1 [文献标识码] A [文章编号] 1673-9701（2018）12-0028-03

Clinical application effect of laparoscopic enucleation of thyroid benign tumor

LIU Yufei PAN Xingyan XIAO Aixia

Department of Thyroid，Breast，Burns and Plastic Surgery，Tongren People's Hospital in Guizhou Province，Tongren 554300，China

[Abstract] Objective To explore the treatment and effect of laparoscopic enucleation of thyroid benign tumor in patients with thyroid benign tumors. Methods 60 patients with thyroid benign tumor who were hospitalized in our department from January 2016 to February 2017 were selected as the study subjects. After the admission， conventional endoscopic thyroid tumor resection（observation group） and open enucleation of thyroid benign tumor（control group）were introduced to the patients and the surgical ways were decided by the patients. The operative time， intraoperative blood loss， incision drainage volume， postoperative analgesia requirement， hospital stay， hospitalization costs， and cosmetic satisfaction were compared between the two groups. Results The cosmetic satisfaction of the observation group was higher than that of the control group（P<0.05）. The operation time， intraoperative blood loss， incision drainage volume， hospital stay and hospitalization cost of the observation group were better than those of the control group（P<0.05）. The quality of life between the two groups was similar before the intervention（P>0.05）. The quality of life in the observation group after intervention was better than that in the control group（P<0.05）. The need for postoperative analgesia was lower in the observation group than that in the control group（P<0.05）. Conclusion The laparoscopic enucleation of thyroid benign tumor in the treatment of patients with benign thyroid tumor has positive effect， which can effectively remove the disease， reduce the need for postoperative analgesia， improve the quality of life， shorten the operation and hospital stay， reduce medical costs and the amount of bleeding.

[Key words] Thyroid benign tumor； Endoscopy； Blood loss； Quality of life

甲状腺肿瘤是常见的甲状腺疾病，以良性肿瘤多见。近年来，甲状腺肿瘤患者的发病率以5.3%的速度在持续快速增长，其发病越来越年轻化，女性明显高于男性。甲状腺肿瘤采取外科手术治疗仍是一种安全而有效的方式，目前主要有传统的开放甲状腺手术（conventional thyroid-dectomy，CT）和腔镜甲状腺手术（endoscop icthyroidectomy，ETE）两种。传统手术后，颈部多留下6～8 cm长的手术瘢痕，既影响美观，又给患者造成较大的心理负担；腔镜甲状腺手术通过腔镜手术特有的手术病灶与切口缩小、转移与隐藏，术后颈部无切口瘢痕，美观效果好，越来越受到众多患者的青睐。另外，由于腔镜的放大作用，重要的神经和血管可以显露清楚，从而避免了这些结構的损伤[1]。本研究分析了甲状腺良性肿瘤患者行腔镜甲状腺良性肿瘤摘除术的治疗及效果，现报道如下。

1资料与方法