李俊生
LI Junsheng

• 1:通城县同仁医院

摘要(Abstract)：

目的:探讨经胸乳晕入路腔镜与传统开放手术治疗CN0 stage期甲状腺癌的临床效果。方法:86例CN0 stage期甲状腺癌患者按盲法随机分为对照组40例(传统开放手术治疗)和观察组46例(经胸乳晕入路腔镜术治疗),比较两组手术的手术时间、切口长度、术中出血量及住院时间、术后1个月时评估临床疗效,术后3个月时进行视觉模拟疼痛(VAS)评分和Vancouver疤痕评定量表(VSS)评分及随访并发症。结果:观察组手术时间长于对照组,住院时间短于对照组,切口长度小于对照组、术中出血量少于对照组,差异有统计学意义(P<0.05);观察组临床总有效率高于对照组,差异有统计学意义(P<0.05),术后观察组VAS评分、VSS评分低于对照组(P<0.05);观察组手术并发症总发生率明显低于对照组,差异有统计学意义(χ2=5.083,P<0.05)。结论:经胸乳晕入路腔镜术治疗CN0 stage期甲状腺癌患者的临床疗效、减轻术后疼痛感、提高美观度及手术安全性方面较传统开放术更具优势。
Objective: To compare the clinical effect of endoscopic operation via mammary areola approach versus traditional open operation in the treatment of CNO stage thyroid cancer. Methods: A total of 86 patients with CNO stage thyroid cancer treated the hospital from February 2015 to February2016 were randomly divided into the control group( treated with traditional open operation,n = 40)and the observation group( treated with endoscopic operation via mammary areola approach,n = 46).The general indicators( operative time,length of incision,intraoperative blood loss,hospital stay),clinical curative effect,visual analogue pain( VAS) scores,Vancouver Scar Scale( VSS) scores and operative safety were compared between the two groups. Results: The operative time of the observation group was significantly longer than that of the control group,while the length of hospital stay,the length of incision and the intraoperative amount of blood loss were significantly shorter/less than those of the control group( P < 0. 05). The clinical total effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). The VAS scores and VSS scores of the observation group were significantly lower than those of the control group( P < 0. 05). There was no permanent parathyroid injury in the two groups after operation. The total incidence of operative complications in the observation group was significantly lower than that in the control group( x2= 5. 083,P <0. 05). Conclusion: Although the time of endoscopic operation via mammary areola approach is longer in the treatment of CN0 stage thyroid cancer,it is better than traditional open operation,reducing postoperative pain and enhancing aesthetic degree and safety.

关键词(KeyWords)： 甲状腺肿瘤;外科手术;疼痛测定;胸乳晕入路腔镜术;传统开放手术
thyroid cancer;surgical operation;pain determination;endoscopic operation via mammary areola approach;traditional open operation

Abstract:

Keywords:

基金项目(Foundation): 湖北省卫计委科研项目(1608672)

作者(Author): 李俊生
LI Junsheng

DOI: 10.19367/j.cnki.1000-2707.2018.06.020

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