本文關(guān)鍵詞： 腔鏡甲狀腺手術(shù) 開(kāi)放甲狀腺手術(shù) 分化型甲狀腺癌 臨床療效　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的比較腔鏡甲狀腺手術(shù)(endoscopic thyroidectomy,ET)與傳統(tǒng)開(kāi)放甲狀腺手術(shù)(open thyroidectomy,OT)治療分化型甲狀腺癌(differentiated thyroid carcinoma,DTC)的臨床療效。方法本研究為回顧性分析。選取2014年1月~2016年9月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院普通外科行腔鏡甲狀腺癌根治術(shù)的27例患者作為腔鏡手術(shù)組,同時(shí)選取30例分化型甲狀腺癌患者作為開(kāi)放手術(shù)組,比較兩組患者手術(shù)時(shí)間、術(shù)中出血量、術(shù)后引流量、術(shù)后住院時(shí)間、術(shù)后止痛藥使用次數(shù)、中央?yún)^(qū)淋巴結(jié)清掃數(shù)量、手術(shù)并發(fā)癥發(fā)生率及腫瘤復(fù)發(fā)率的情況。結(jié)果所有患者均順利完成手術(shù),術(shù)后未發(fā)生嚴(yán)重并發(fā)癥,腔鏡手術(shù)組無(wú)中轉(zhuǎn)開(kāi)放。腔鏡手術(shù)組的手術(shù)時(shí)間及術(shù)后住院時(shí)間比開(kāi)放手術(shù)組長(zhǎng),術(shù)后引流量比開(kāi)放手術(shù)組多,但出血量少,兩組患者上述數(shù)據(jù)比較差別均有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者在中央?yún)^(qū)淋巴結(jié)清掃數(shù)量、術(shù)后止痛藥使用次數(shù)、術(shù)后并發(fā)癥發(fā)生率、腫瘤復(fù)發(fā)率的對(duì)比差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論1、對(duì)于直徑≤4cm、術(shù)前無(wú)淋巴結(jié)轉(zhuǎn)移的早期分化型甲狀腺癌,腔鏡甲狀腺癌手術(shù)是安全可行的,中央?yún)^(qū)淋巴結(jié)清掃數(shù)量可達(dá)到與傳統(tǒng)開(kāi)放手術(shù)相同的效果,但其遠(yuǎn)期效果尚需進(jìn)一步隨訪研究。2、腔鏡甲狀腺癌手術(shù)具有出血量少、切口小及美容效果好的優(yōu)點(diǎn);缺點(diǎn)是手術(shù)時(shí)間及住院時(shí)間長(zhǎng)、術(shù)后引流量多,操作難度大,對(duì)于有廣泛頸淋巴結(jié)轉(zhuǎn)移的病例應(yīng)用受到限制。
[Abstract]:Objective to compare endoscopic thyroid surgery with open thyroidectomy. OT-) was used to treat differentiated thyroid carcinoma of differentiated thyroid carcinoma. DTC). Methods from January 2014 to September 2016, 27 patients underwent endoscopic radical thyroidectomy in general surgery, the first affiliated hospital of Guangxi medical university. Endoscopic group. At the same time, 30 patients with differentiated thyroid carcinoma were selected as open operation group. The operation time, intraoperative bleeding, postoperative drainage, postoperative hospitalization time and postoperative analgesic use were compared between the two groups. The number of central lymph nodes dissection, the incidence of complications and tumor recurrence. Results all patients successfully completed the operation, there were no serious postoperative complications. The operative time and postoperative hospital stay in the endoscopic operation group were longer than those in the open operation group, and the postoperative drainage volume was more than that in the open operation group, but the amount of bleeding was less. There were significant differences in the above data between the two groups (P 0.05). There was no significant difference in the number of lymph node dissection, the number of postoperative analgesic use, the incidence of postoperative complications and the recurrence rate of tumor between the two groups (P 0.05). Conclusion 1. For early differentiated thyroid carcinoma with diameter 鈮，

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