摘要
目的:比较经胸壁入路与低位小切口在甲状腺良性肿瘤切除术患者中的疗效。方法:遴选2020年1月至2023年1月收治的甲状腺良性肿瘤患者，根据手术方式不同分为胸壁入路组（行胸壁入路腔镜甲状腺切除术）与小切口组（行低位小切口甲状腺瘤切除术），经倾向性匹配评分法排除基线资料混杂因素影响，最后两组各纳入84例患者。采用SPSS 22.0软件处理数据，围手术期指标、疼痛评分等计量资料以（）表示，采用独立样本t检验、配对t检验和重复测量方差分析；并发症等计数资料以χ2检验分析。P<0.05表示差异有统计学意义。结果:胸壁入路组患者手术时间、术中出血量显著高于小切口组（P<0.05），术后引流量、切口长度、并发症总发生率显著低于小切口组（P<0.05）；术后3 d、1周，胸壁入路组患者简化McGill疼痛量表（SF-MPQ）评分较术后1 d均显著降低，不同时间点比较差异有统计学意义（P<0.05），且胸壁入路组患者术后1 d、3 d的SF-MPQ评分显著低于小切口组（P<0.05）；术后1个月，胸壁入路组患者温哥华瘢痕评定量表（VSS）评分显著低于小切口组（P<0.05）。结论:经胸壁入路与低位小切口甲状腺良性肿瘤切除术均具有较好效果，但经胸壁入路手术切口更小，疼痛程度更低，切口美观度更高，值得推荐。
Abstract
Objective:To compare the efficacy of transthoracic approach and low small incision in patients with benign thyroid tumor resection.Methods:Patients with benign thyroid tumors admitted from January 2020 to January 2023 were selected and divided into chest wall approach group (endoscopic thyroidectomy via chest wall approach) and small-incision group (resection of thyroidoma via low-incision) according to different surgical methods. The influence of baseline data confounders was excluded by the trend matching score method. The last two groups included 84 patients each. SPSS 22.0 software was used to process the data. Perioperative indicators, pain scores and other measurement data were expressed as (). Independent sample t test, paired t test and repeated measurement ANOVA were used. The statistical data of complications were analyzed by χ2 test. P<0.05 indicated that the difference was statistically significant.Results:The operative time and intraoperative blood loss in the chest wall approach group were significantly higher than those in the small incision group (P<0.05), and the postoperative drainage volume, incision length and total complication rate were significantly lower than those in the small incision group (P<0.05). The simplified McGill Pain Scale (SF-MPQ) scores of patients in the chest wall approach group were significantly lower than those in the postoperative 1d and 1 week, with statistical significance at different time points (P<0.05), and the SF-MPQ scores of patients in the chest wall approach group were significantly lower than those in the small incision group (P<0.05). One month after surgery, the Vancouver Scar Rating Scale (VSS) score in the chest wall approach group was significantly lower than that in the small incision group (P<0.05).Conclusion:Both the transthoracic approach and the low small incision have good results in the resection of benign thyroid tumors, but the transthoracic approach has smaller incision, lower pain degree and higher incision aesthetics, which is recommended.
基金项目
2022年四川省卫生信息学会年度申报项目科研课题(2022036)
万方数据