无充气经腋窝入路与经胸乳入路手术治疗甲状腺癌的疗效分析OACSTPCD
Efficacy of non-inflatable transaxillary approach and transthoracic approach surgery in treatment of thyroid cancer
目的 分析无充气经腋窝入路与经胸乳入路手术治疗甲状腺癌的临床疗效,并对患者术后并发症发生情况进行分析.方法 对2019年10月至2022年11月于我院行手术治疗的88例甲状腺癌患者的临床资料进行分析,根据手术方式将其分为A、B组.A组45例患者行无充气经腋窝入路完全腔镜甲状腺手术治疗,B组43例患者采用经胸乳入路腔镜甲状腺手术治疗.对2组患者围术期各项指标、手术切口美观满意度、术后疼痛情况及并发症发生情况进行对比.分析影响并发症发生的主要因素.结果 A组患者手术切口美观总满意度明显高于B组(P<0.05);A组患者术中出血量、术后引流量明显少于B组(P<0.05).2组患者术后3 d、5 d的VAS评分明显低于术后1 d(P<0.05),且术后5 d低于术后3 d(P<0.05).A组术后并发症发生率明显低于B组(P<0.05).Logistic回归分析显示,术中出血量是术后并发症发生的独立影响因素(P<0.05).结论 无充气经腋窝入路与经胸乳入路手术治疗甲状腺癌均有效,但无充气经腋窝入路手术切口隐蔽,术后美观度更高,术中出血量、术后引流量及术后并发症也更少.术中出血量较多是导致术后并发症发生的主要因素.
Objective To analyze the clinical efficacy of non-inflatable transaxillary approach and transthoracic approach surgery for thyroid cancer,and analyze the occurrence of postoperative complications in patients.Methods The clinical data of 88 patients with thyroid cancer who underwent surgical treatment in our hospital from October 2019 to November 2022 were analyzed.They were divided into group A and B according to the surgical method.Forty-five patients in group A received complete endoscopic thyroidectomy through the non-inflatable axillary approach,while 43 patients in group B received endoscopic thyroidectomy through the thoracic approach.The perioperative indicators,satisfaction with surgical incision,postoperative pain,and incidence of complications of patients in the two groups were compared.And the main influence factors for the occurrence of complications were analyzed.Results The total satisfaction rate for surgical incision of patients in group A was significantly higher than that in group B(P<0.05);while the intraoperative bleeding volume and postoperative drainage volume of patients in group A were significantly lower than those in group B(P<0.05).The VAS score 3 and 5 days after surgery were significantly lower than that 1 day after surgery(P<0.05),and the VAS score 5 days after surgery was lower than that 3 days after surgery(P<0.05).The incidence of postoperative complications in group A was significantly lower than that in group B(P<0.05).Logistic regression results showed that intraoperative bleeding volume was the independent influencing factor for postoperative complications(P<0.05).Conclusion Both non-inflatable transaxillary approach and transthoracic approach surgery are effective for thyroid cancer,but the non-inflatable transaxillary approach surgery has the advantages of concealed incision,higher postoperative aesthetics,and less intraoperative bleeding volume,postoperative drainage volume and postoperative complications.Excessive intraoperative bleeding is the main factor leading to postoperative complications.
舒乐;黄湘俊;彭书旺;李澜
湖南中医药大学第一附属医院胃肠甲状腺血管外科,湖南 长沙 410007
临床医学
腔镜无充气经腋窝入路经胸乳入路甲状腺癌疗效并发症
endoscopenon-inflatable transaxillary approachtransthoracic approachthyroid cancerefficacycomplication
《局解手术学杂志》 2024 (002)
166-169 / 4
2021年度湖南省卫生健康委科研课题(202104010382)
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