段飞　詹善强　桂誉淋　邹辉文

【摘要】 目的：探究侧颈切口在局限于单侧腺叶内的甲状腺结节手术中的应用效果。方法：选取2018年1月-2020年6月80例局限于单侧腺叶内的甲状腺结节手术患者，根据随机数字表法将其分为对照组和观察组，每组40例。对照组采用传统低领式甲状腺切除术，观察组采用侧颈切口甲状腺切除术。比较两组的住院时间、术中出血量、手术时间、切口長度、并发症发生情况及术后1、3、6个月的瘢痕情况（温哥华瘢痕量表评分）、颈部疼痛（NRS评分）及美观满意度。结果：观察组的住院时间、手术时间、切口长度均短于对照组，术中出血量少于对照组，差异均有统计学意义（P<0.05）。两组并发症发生率比较，差异无统计学意义（P>0.05）。术后1、3、6个月，观察组色泽、血管、厚度、柔软度评分均低于对照组，差异均有统计学意义（P<0.05）。术前，两组NRS评分比较，差异无统计学意义（P>0.05）;术后1、3、6个月，观察组的NRS评分均优于对照组，差异均有统计学意义（P<0.05）。术后1、3、6个月，观察组的美观满意度均优于对照组，差异均有统计学意义（P<0.05）。结论：侧颈切口在局限于单侧腺叶内的甲状腺结节手术中的应用效果较好，且美观程度较高，因此在本类患者中的应用价值较高。

【关键词】 侧颈切口 单侧腺叶 甲状腺结节

Application of Lateral Neck Incision in the Surgical Treatment of Thyroid Nodules Confined to Unilateral Glandular Lobes/DUAN Fei， ZHAN Shanqiang， GUI Yulin， ZOU Huiwen. //Medical Innovation of China， 2021， 18（23）： 0-052

[Abstract] Objective： To investigate the application effect of lateral neck incision in the surgical treatment of thyroid nodules confined to unilateral glandular lobes. Method： A total of 80 patients with thyroid nodules confined to unilateral glandular lobes from January 2018 to June 2020 were selected， and they were divided into control group and observation group according to the method of random number table， 40 cases in each group. The control group was treated with traditional low collar thyroidectomy， the observation group was treated with thyroidectomy through lateral neck incision. The length of stay， intraoperative blood loss， duration of operation， incision length， incidence of complications were compared between the two groups， scar condition （vancouver scar scalevss）， neck pain （NRS scores） and aesthetic satisfaction at 1， 3， 6 months after surgery were compared between two groups. Result： The length of stay， duration of operation， incision length of the observation group were shorter than those of the control group， the intraoperative blood loss of the observation group was less than that of the control group， the differences were statistically significant （P<0.05）. There was no significant difference in the incidence of complications between two groups （P>0.05）. At 1， 3 and 6 months after surgery， the color， blood vessel， thickness and softness scores of the observation group were lower than those of the control group， the differences were statistically significant （P<0.05）. Before surgery， there was no significant difference in NRS scores between two groups （P>0.05）; at 1， 3 and 6 months after surgery， the NRS scores of the observation group were superior than those of the control group， the differences were statistically significant （P<0.05）. At 1， 3 and 6 months after surgery， the aesthetic satisfaction of the observation group were superior than those of the control group， the differences were statistically significant （P<0.05）. Conclusion： Lateral neck incision has a good effect in the treatment of thyroid nodules confined to unilateral glandular lobes， and has a high aesthetic degree， so it has a high application value in this type of patients.

[Key words] Lateral neck incision Unilateral glandular lobes Thyroid nodules

First-author’s address： The First People’s Hospital of Jiujiang， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.23.012

甲狀腺结节相关手术在临床具有极高的应用率，其手术各方面的研究也是临床重点与热点，其中关于手术方式及手术切口的研究占比较高。既往多采用低领式甲状腺切除手术进行治疗，效果较好，但是其美观程度不足，且围术期的出血量、并发症发生情况等多方面仍有待进一步控制，因此找到更为有效、美观程度更高的手术方式成为临床的研究重点[1-2]。……