林少标 谢宁 张静宜 刘小飞 郭朝晖

【摘要】 目的：對比甲状腺乳头状癌（PTC）患者行传统开放手术和经全乳晕腔镜手术的效果。方法：选取2018年1月-2019年10月笔者所在医院62例确诊为PTC的患者，按简单随机分组法分为对照组和观察组，每组31例。对照组行传统开放式手术，观察组行经全乳晕腔镜手术。观察两组临床疗效、手术情况、美容效果及并发症情况。结果：观察组总有效率显著高于对照组（字2=5.41，P=0.02）。观察组手术时间、住院时间与颈部恢复活动时间均短于对照组，术中出血量少于对照组，差异均有统计学意义（P<0.05）。观察组术后1、3个月NSS评分均显著高于对照组，差异均有统计学意义（P<0.05）。观察组并发症发生率为12.90%，显著低于对照组的35.48%，差异均有统计学意义（P<0.05）。结论：经全乳晕腔镜手术具有手术时间短、出血量少、患者恢复快、美容效果显著及并发症少等优势，值得临床推广。

【关键词】 PTC 传统开放手术 经全乳晕腔镜手术 美容效果

doi：10.14033/j.cnki.cfmr.2020.19.054 文献标识码 B 文章编号 1674-6805（2020）19-0-03

A Comparative Study on the Effect of Traditional Open Surgery and Endoscopic Surgery via Total Areola in Patients with Papillary Thyroid Carcinoma/LIN Shaobiao， XIE Ning， ZHANG Jingyi， LIU Xiaofei， GUO Chaohui. //Chinese and Foreign Medical Research， 2020， 18（19）： -134

[Abstract] Objective： To compare the effects of traditional open surgery and endoscopic surgery via total areola in patients with papillary thyroid carcinoma （PTC）. Method： A total of 62 patients diagnosed with PTC in our hospital from January 2018 to October 2019 were divided into the control group and the observation group according to the simple randomization method， with 31 cases in each group. The control group underwent traditional open surgery， and the observation group underwent endoscopic surgery via total areola. The clinical effect， operation， cosmetic effect and incidence of complications were observed. Result： The total effective rate of the observation group was significantly higher than that of the control group （字2=5.41， P=0.02）. The operation time， hospitalization time and neck recovery activity time of the observation group were shorter than those of the control group， and the amount of intraoperative bleeding was less than that of the control group， and the differences were statistically significant （P<0.05）. The NSS scores of the observation group at 1 and 3 months after operation were significantly higher than those of the control group， and the differences were statistically significant （P<0.05）. The incidence of complications in the observation group was 12.90%， which was significantly lower than 35.48% of the control group， and the difference was statistically significant （P<0.05）. Conclusion： Endoscopic surgery via total areola has the advantages of short operation time， less bleeding， quick recovery of patients， significant cosmetic effect and fewer complications， which is worthy of clinical promotion.

[Key words] PTC Traditional open surgery Endoscopic surgery via total areola Cosmetic effect

First-authors address： The Sixth Peoples Hospital of Huizhou， Huizhou 516211， China

甲状腺乳头状癌（PTC）是一种常见的恶性肿瘤，近年来发病率逐年升高，尤以女性患者多见[1]。治疗本病的有效手段为手术，传统的颈前区开放性甲状腺乳头状癌根治术虽然有较好的治疗效果，但创伤较大，术后并发症较多，且易留下明显的瘢痕，使得女性患者在治疗时有所顾虑[2]。近年来，随着微创技术的不断发展，经锁骨下、腋下、胸乳入路及全乳晕入路等位置的腔镜甲状腺手术发展迅速，能够在治疗疾病和缓解疼痛的基础上显著减小切口，达到快速恢复和美容、美观的目的。目前，关于传统开放手术和经全乳晕腔镜手术治疗PTC的比较研究鲜少[3]。因此，本研究旨在对比分析PTC患者行传统开放手术和经全乳晕腔镜手术的临床效果，报道如下。

1 资料与方法

1.1 一般资料

选取2018年1月-2019年10月笔者所在医院62例确诊为PTC的患者。……