张林

[摘要] 目的 對比改良小切口手术与传统甲状腺切除术治疗甲状腺腺瘤的临床疗效。 方法 采用分层抽样法抽选2014年9月至2020年7月我院耳鼻咽喉头颈外科收治的329例甲状腺腺瘤患者纳入本实验，并采用均等双盲划分法将其中164例纳入对照组，予以传统甲状腺切除术治疗，其余165例纳入观察组，予以行颈前小切口腔镜辅助下甲状腺手术治疗。比较两组手术相关指标（术中出血量、手术时间、切口长度及住院时间）、疼痛程度、手术疗效、并发症及满意度等。 结果 观察组的术中出血量显著少于对照组，手术时间、切口长度及住院时间显著短于对照组（P<0.05）。观察组的手术优良率为95.76%，显著高于对照组的84.15%（P<0.05）。术后3 d至7 d，两组VAS评分较术前均有所降低，其中观察组VAS评分在术后3 d、5 d、7 d明显低于对照组（P<0.05），观察组的并发症发生率为3.64%，显著低于对照组的12.80%（P<0.05）;观察组对手术切口瘢痕的满意度为93.94%，显著高于对照组的73.17%（P<0.05）。 结论 采用改良小切口手术治疗甲状腺腺瘤临床疗效更加显著，有操作简单、恢复快、创伤小和并发症较少等优点，能使患者早日康复，可在临床借鉴推广。

[关键词] 改良小切口手术;传统甲状腺切除术;甲状腺腺瘤;腔镜

[中图分类号] R736.1          [文献标识码] A          [文章编号] 1673-9701（2021）07-0034-04

Comparison of clinical efficacy between modified small incision surgery and traditional thyroidectomy in the treatment of thyroid adenoma

ZHANG Lin

Department of Otorhinolaryngology Head and Neck Surgery， the Second Affiliated Hospital of Xiamen Medical College， Xiamen   361021， China

[Abstract] Objective To compare the clinical efficacy of modified small incision surgery and traditional thyroidectomy in the treatment of thyroid adenoma. Methods A total of 329 patients with thyroid adenoma admitted to Otorhinolaryngology Head and Neck Surgery in this hospital from September 2014 to July 2020 were selected by stratified sampling method. 164 cases were taken as the control group by equal double-blind method， and the remaining 165 cases were included in the observation group. The control group was treated with traditional thyroidectomy， while the observation group was treated with endoscopic thyroidectomy. The operation-related indexes（intraoperative blood loss， operation time， incision length and hospitalization time）， pain degree， operation effect， complications and satisfaction were observed and compared between the two groups. Results Compared with the control group， the observation group had significantly less intraoperative blood loss， shorter operation time， smaller incision and shorter hospital stay（P<0.05）. The excellent rate of operation in the observation group was 95.76%， which was significantly higher than that in the control group（84.15%， P<0.05）. VAS scores of both groups decreased from 3 days to 7 days after operation. VAS score of the observation group was significantly lower than that of the control group at 3， 5 and 7 days after operation（P<0.05）， and the complication rate of the observation group was 3.64%， which was significantly lower than that of the control group（12.80%， P<0.05）. The satisfaction of the observation group with scar was 93.94%， significantly higher than that of the control group（73.17%， P<0.05）. Conclusion The modified small incision surgery is more effective in treating thyroid adenoma. It has the advantages of simple operation， quick recovery， less trauma and fewer complications， which can be promoted in clinical practice.

[Key words] Modified small incision surgery; Traditional thyroidectomy; Thyroid adenoma; Laparoscopy

甲状腺腺瘤是一种良性肿瘤，好发于女性患者。甲状腺腺瘤早期临床表现不明显，随着疾病的进展，患者可出现乏力、消瘦等现象，具有恶性病变的可能性，对患者的生命健康造成威胁[1]。因此，在手术条件具备的前提下，临床多主张开展手术治疗。传统上采用的甲状腺切除术虽能有效解除患者的临床症状，但切口大、涉及范围广、频繁的手术机械操作将会引起多种并发症，影响其术后康复[2]。因此改良小切口手术应运而生，此术式一般需要借助内镜下操作，具有切口小且视野清晰等优势，近年来受到临床广泛关注[3]。我院耳鼻咽喉头颈外科为寻找更好的甲状腺腺瘤治疗方法，以2014年9月至 2020年7月我科收治的329例甲状腺腺瘤患者作为研究对象，对改良小切口手术与传统甲状腺切除术进行比较分析，现报道如下。……