摘要
目的:分析经颏下前庭入路腔镜术式与胸乳入路腔镜术式在甲状腺单侧良性肿瘤切除术中的应用疗效。方法:选择2022年1月至2023年6月收治的44例行腔镜手术的单侧甲状腺肿瘤患者,按手术方式分为颏下前庭入路组(22例)与胸乳入路组(22例)。比较2组手术相关指标、并发症发生率、疼痛程度、术后颈部舒适度、美容效果及主观满意度评分等。结果:颏下前庭入路组在降低手术时长、减少术中出血量、术后第1天引流量方面较胸乳入路组存在优势,差异有统计学意义(P<0.05)。2组在手术前后甲状旁腺素差值、血钙差值、术后总引流量、拔管时间、住院时间、肿瘤的病理性质、并发症发生率等方面比较差异无统计学意义(P>0.05)。在减少疼痛程度方面,颏下前庭入路组较胸乳入路组存在优势,2组术后6 h、24 h、72 h VAS疼痛评分比较差异有统计学意义(P<0.05)。2组术后患者主观颈部舒适度、主观满意度评分比较差异无统计学意义(P>0.05),但术后美容效果比较,颏下前庭组温哥华瘢痕评分优于胸乳入路组,差异有统计学意义(P<0.05)。结论:2种手术方式均安全可行,但在控制手术时长、减轻手术创伤、提高手术满意度方面,颏下前庭入路可能比胸乳入路具有优势。
Objective:To analyze the clinical efficacy of endoscopic surgery via submental vestibular approach and thoracic breast approach in the resection of unilateral benign thyroid tumors.Methods:A total of 44 patients with unilateral thyroid tumor who were willing to undergo endoscopic surgery from January 2022 to June 2023 were selected and divided into submental vestibular approach group(22 cases)and thoracic and breast approach group(22 cases)by Mode of operation.The surgery related indexes,complication rate,pain degree,postoperative neck comfort,aesthetic effect and subjective satisfaction score were compared between the two groups.Results:The submental vestibular approach was superior to the thoracic and breast approach in reducing the duration of operation,the amount of blood lost during operation and the amount of drainage on the first day after operation,with statistical significance(P<0.05).There were no significant differences in parathyroid difference before and after operation,blood calcium difference,total drainage volume,extubation time,hospital stay,pathological nature of tumor and incidence of complications between the two groups(P>0.05).In terms of pain reduction,the submental vestibular approach group had an advantage over the thoracic and breast approach group,and there were statistically significant differences in VAS pain scores at 6,24 and 72 h after surgery(P<0.05).There were no statistically significant differences in the scores of subjective neck comfort and subjective satisfaction between the two groups(P>0.05),but there were statistically significant differences in postoperative cosmetic effects,and the Vancouver scar score of the submental vestibular group was better than that of the breast approach group(P<0.05).Conclusion:The two surgical methods are safe and feasible,but the submental vestibular approach may be superior to the thoracic and breast approach in controlling operation duration,reducing surgical trauma and improving surgical satisfaction.
作者
彭涛
PENG Tao(The First People's Hospital of Jiujiang,Jiujiang,Jiangxi 332000)
出处
《赣南医科大学学报》
2024年第9期899-904,910,共7页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
