本文選題：腋窩入路　切入點：良性甲狀腺疾病　出處：《廣西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的探討經(jīng)腋窩入路腔鏡甲狀腺手術(shù)中喉返神經(jīng)暴露組與非暴露組的必要性,可行性及臨床對比研究,從而提升內(nèi)鏡甲狀腺手術(shù)質(zhì)量及安全性。方法本研究為回顧性分析。選取77例良性甲狀腺疾病患者,其手術(shù)方式均為經(jīng)腋窩入路。按照術(shù)中是否進行暴露喉返神經(jīng)分為2個研究組：其中暴露組49例,非暴露組28例的病例資料以及隨訪資料。進行總結(jié)和比較兩組喉返神經(jīng)損傷,手術(shù)時間,術(shù)中出血量,住院天數(shù),以及其他并發(fā)癥發(fā)生率,推斷兩種手術(shù)方式的優(yōu)缺點,從而評價其臨床價值。結(jié)果77例手術(shù)均在經(jīng)腋窩入路腔鏡下完成,無中轉(zhuǎn)開放手術(shù)。暴露喉返神經(jīng)組49例當(dāng)中有0例喉返神經(jīng)損傷,其損傷率為(0%)；非暴露組28例當(dāng)中有5例喉返神經(jīng)損傷,其損傷率為(17.85%),均經(jīng)電子喉鏡檢查證實；暴露組明顯低于非暴露組,兩組喉返神經(jīng)損傷率差異有統(tǒng)計學(xué)意義(X2=9.649,P=0.0020.05),兩組手術(shù)時間(t=-0.195,P=0.846),住院天數(shù)(t=1.423,P=0.156),術(shù)中出血均(t=1.423,P=0.156)均無統(tǒng)計學(xué)意義。結(jié)論經(jīng)腋窩入路腔鏡甲狀腺手術(shù)中暴露喉返神經(jīng)能有效防止喉返神經(jīng)損傷,并且未增加手術(shù)并發(fā)癥,對于結(jié)節(jié)性甲狀腺腫、行甲狀腺腺葉次全切、或腫塊數(shù)目多,應(yīng)該常規(guī)進行解剖暴露喉返神經(jīng)。
[Abstract]:Objective to explore the necessity, feasibility and clinical comparison of recurrent laryngeal nerve exposure group and non-exposure group in endoscopic thyroidectomy via axillary approach. In order to improve the quality and safety of endoscopic thyroid surgery, 77 patients with benign thyroid disease were selected for retrospective analysis. According to whether the recurrent laryngeal nerve was exposed during the operation, the patients were divided into two groups: 49 cases in the exposed group, 28 cases in the non-exposed group, and the follow-up data. The injury of the recurrent laryngeal nerve was summarized and compared between the two groups. The time of operation, the amount of blood lost during operation, the length of hospitalization, the incidence of other complications, and the advantages and disadvantages of the two surgical methods were inferred to evaluate their clinical value. There were 0 cases of recurrent laryngeal nerve injury in 49 cases of exposed recurrent laryngeal nerve group, 5 cases of recurrent laryngeal nerve injury in 28 cases of non-exposure group, and 17.85% injury rate of recurrent laryngeal nerve injury, all of which were confirmed by electronic laryngoscopy. The exposure group was significantly lower than the non-exposed group. There was no significant difference in the injury rate of recurrent laryngeal nerve between the two groups. There was no significant difference in the injury rate of recurrent laryngeal nerve between the two groups. Conclusion exposure of recurrent laryngeal nerve through axillary approach can effectively prevent recurrent laryngeal nerve injury during endoscopic thyroidectomy. For nodular goiter subtotal thyroidectomy or large number of masses the recurrent laryngeal nerve should be dissected routinely.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R653

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本文編號：1673984