超声刀经胸乳入路腔镜下行甲状腺癌根治术的效果观察(1)
[摘要] 目的 研究超声刀经胸乳入路腔镜下行甲状腺癌根治术的效果及对并发症的影响。 方法 回顾性分析本院2012年7月～2014年7月行手术治疗的104例甲状腺癌患者，采用传统开放手术的患者为对照组，采用超声刀经胸乳入路腔镜下行甲状腺癌根治术的患者为观察组，比较两组患者的术中出血量、手术时间、术后引流量及住院时间、术后疼痛及并发症发生情况。 结果 观察组的术中出血量、术后引流量显著少于对照组，手术时间、住院时间均显著短于对照组(P<0.05)；观察组术后3 d内的疼痛评分低于对照组(P<0.05)。观察组术后声音嘶哑、暂时性低钙、手足麻木、发音困难并发症发生率与对照组差异无统计学意义(P>0.05)，但术后总并发症发生率显著低于对照组(P<0.05)。 结论 超声刀经胸乳入路腔镜下行甲状腺癌根治术具有术中出血量少、手术时间短、术后引流量少、住院时间短、术后前期患者疼痛较轻以及术后并发症发生率低等优势，手术效果可靠，是甲状腺癌较为理想的治疗方式。
[关键词] 超声刀；经胸乳入路；腔镜；甲状腺癌
[中图分类号] R736.1 [文献标识码] A [文章编号] 1674-4721(2015)05(b)-0065-03
Effect observation of thyroid cancer radical mastectomy using harmonic scalpel by pectoral breast approch under thoracoscopy
JIANG Liang GAO Xiao-shang HU Rong-xiang GONG Xiao-yu
Department of General Hepatobiliary Surgery，Gaoyao People′s Hospital of Guangdong Province，Gaoyao 526000，China
[Abstract] Objective To study the effect of thyroid cancer radical mastectomy using harmonic scalpel by pectoral breast approch under thoracoscopy and the influence of surgery on complication. Methods 104 patients with thyroid cancer treated by surgery from July 2012 to July 2014 were retrospectively analyzed，control group was given traditional open surgery，and observation group was given thyroid cancer radical mastectomy by pectoral breast approch under thoracoscopy.Amount of bleeding during operation， operative time，postoperative drainage volume and hospital stay，postoperative pain and complication in patients between two groups were compared. Results Amount of bleeding during operation，postoperative drainage volume in observation group was obviously less than that of control group respectively，operative time and hospital stay was obviously shorter than that of control group respectively (P<0.05).The postoperative pain score within 3 days after operation in observation group was lower than that of control group (P<0.05).There was no statistical difference of the incidence rate of complication (hoarseness，temporary low calcium，deadlimb，and pronunciation difficulty) after operation between two groups (P>0.05)，but the total incidence rate of postoperative complication in observation group was significantly lower than that of control group (P<0.05). Conclusion Thyroid cancer radical mastectomy by pectoral breast approch under thoracoscopy has the advantage of less amount of bleeding during operation，shorter operation stay，less postoperative drainage volume，and shorter hospital stay and lighter pain in early stage after operation and lowed incidence rate of postoperative complication，operation effect is reliable.It is ideal treatment method in thyroid cancer. (江亮 高小尚 胡荣祥 龚晓玉)
[关键词] 超声刀；经胸乳入路；腔镜；甲状腺癌
[中图分类号] R736.1 [文献标识码] A [文章编号] 1674-4721(2015)05(b)-0065-03
Effect observation of thyroid cancer radical mastectomy using harmonic scalpel by pectoral breast approch under thoracoscopy
JIANG Liang GAO Xiao-shang HU Rong-xiang GONG Xiao-yu
Department of General Hepatobiliary Surgery，Gaoyao People′s Hospital of Guangdong Province，Gaoyao 526000，China
[Abstract] Objective To study the effect of thyroid cancer radical mastectomy using harmonic scalpel by pectoral breast approch under thoracoscopy and the influence of surgery on complication. Methods 104 patients with thyroid cancer treated by surgery from July 2012 to July 2014 were retrospectively analyzed，control group was given traditional open surgery，and observation group was given thyroid cancer radical mastectomy by pectoral breast approch under thoracoscopy.Amount of bleeding during operation， operative time，postoperative drainage volume and hospital stay，postoperative pain and complication in patients between two groups were compared. Results Amount of bleeding during operation，postoperative drainage volume in observation group was obviously less than that of control group respectively，operative time and hospital stay was obviously shorter than that of control group respectively (P<0.05).The postoperative pain score within 3 days after operation in observation group was lower than that of control group (P<0.05).There was no statistical difference of the incidence rate of complication (hoarseness，temporary low calcium，deadlimb，and pronunciation difficulty) after operation between two groups (P>0.05)，but the total incidence rate of postoperative complication in observation group was significantly lower than that of control group (P<0.05). Conclusion Thyroid cancer radical mastectomy by pectoral breast approch under thoracoscopy has the advantage of less amount of bleeding during operation，shorter operation stay，less postoperative drainage volume，and shorter hospital stay and lighter pain in early stage after operation and lowed incidence rate of postoperative complication，operation effect is reliable.It is ideal treatment method in thyroid cancer. (江亮 高小尚 胡荣祥 龚晓玉)