摘要
目的 探讨锁骨下单切口入路腔镜甲状腺手术对甲状腺癌患者的疗效。方法 选取2022年7月~2024年6月锦州医科大学附属第一医院收治的132例拟行甲状腺手术治疗的甲状腺癌患者,依据手术入路方式的不同,分为A组(传统颈前入路开放手术,68例)和B组(锁骨下单切口入路腔镜手术,64例)。对比两组患者手术相关指标、疼痛状况、甲状腺功能、切口美容满意度及术后并发症发生情况。结果 B组手术时间长于A组,术中出血量低于A组,术后引流量高于A组(均P<0.05);两组引流管拔除时间、住院时间对比,无统计学差异(均P>0.05)。B组术后3 d、术后7 d及术后1个月VAS评分均低于A组(均P<0.05)。B组术后3 d的TSH、FT3及FT4水平均高于A组(均P<0.05)。术后3个月,B组切口美容满意度高于A组(χ^(2)=10.534,P=0.001)。两组术后并发症总发生率对比,无统计学差异(χ^(2)=0.706,P=0.401)。结论 锁骨下单切口入路腔镜甲状腺手术治疗甲状腺癌,患者术中出血量少,术后疼痛较轻,对甲状腺功能的影响小,切口美容满意度高,且安全可靠。
Objective To explore the efficacy of endoscopic thyroidectomy via subclavian single incision in treatment of pa-tients with thyroid cancer.Methods In this study,132 thyroid cancer patients who underwent thyroid surgery at the First Affil-iated Hospital of Jinzhou Medical University from July 2022 to June 2024 were selected.Based on the surgical approach,the pa-tients were divided into Group A(traditional anterior neck approach open surgery,68 cases)and Group B(subclavicular single-in-cision laparoscopic surgery,64 cases).The surgical-related indicators,pain levels,thyroid function,incision cosmetic satisfac-tion,and postoperative complications were compared between the two groups.Results The surgery time in Group B was longer than that in Group A,but the intraoperative blood loss in Group B was lower than that in Group A,and the postoperative drain-age volume in Group B was higher than in Group A(all P<0.05).There was no significant difference in the drainage tube re-moval time and hospitalization duration between the two groups(all P>0.05).The VAS scores at 3 days,7 days,and 1 month after surgery were all lower in Group B than in Group A(all P<0.05).The levels of TSH,FT3,and FT4 at 3 days post-surgery were higher in Group B than in Group A(all P<0.05).At 3 months post-surgery,the cosmetic satisfaction with the incision in Group B was higher than in Group A(χ^(2)=10.534,P=0.001).There was no significant difference in the overall incidence of postoperative complications between the two groups(x=0.706,P=0.401).Conclusion Endoscopic thyroidectomy via subcla-vian single incision is safe and reliable,with less blood loss,less postoperative pain,less influence on thyroid function and high cosmetic satisfaction.
作者
李纪男
刘淑珍
李鹏
刘杨军
Li Ji'nan;Liu Shuzhen;Li Peng(Department of General Surgery,First Af filiated Hospital of Jinzhou Medical University,Jinzhou 121000,China)
出处
《华中科技大学学报(医学版)》
北大核心
2025年第4期566-570,共5页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
基金
辽宁省锦州市科技指导性计划项目(No.JZ2023B051)。
关键词
甲状腺癌
腔镜甲状腺手术
锁骨下单切口入路
疗效
美容效果
thyroid cancer
endoscopic thyroid surgery
subclavicular incision approach
therapeutic effect
cos-metic effect
