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目的：通过临床非随机性对照研究，比较经胸前壁入路内镜甲状腺手术与传统甲状腺手术在手术时间、术中出血量、术后引流量、术后疼痛、功能恢复、术后住院时间、住院费用及美容效果上的不同，探讨经胸前壁入路内镜甲状腺手术的可行性及临床效果。方法：回顾性分析86 例甲状腺手术，其中46 例患者采用经胸前壁入路内镜甲状腺手术的患者为内镜组，40 例行传统甲状腺手术为传统组。结果：两组患者均顺利完成手术，术后恢复良好，均未发生术后大出血、喉返神经、喉上神经及甲状旁腺损伤等并发症。两组患者的术后住院时间及术后引流量无显著差异。与传统组比较，内镜组手术时间明显延长（P<0.05），术中出血量明显减少（P<0.05），术后疼痛明显降低（P<0.05），功能恢复即术后自行下床洗漱时间明显缩短（P<0.05），住院费用显著增加（P<0.05），手术美容效果满意度明显提高（P<0.05）。结论：相对传统甲状腺手术，经胸前壁入路内镜甲状腺手术具有切口小、出血量少、术后疼痛轻、功能恢复快、美容满意度高等优点，是治疗甲状腺疾病安全、有效的手术方法。

英文摘要:

Objective: To evaluate the clinical benefits of breast approach endoscopic thyroidectomy by comparing the operative time，operative hemorrhage, postoperative drainage, postoperative pain, functional recovery，hospitalization time, cost of hospitalization and cosmetic satisfaction in a clinical n onrandomness study. Method: To review eighty-six patients who underwe nt thyroidectomy, fortysix patients who underwent endoscopic thyroidectomy were enrolled endoscopic group and forty patients who underwent conventional thyroidectomy were enrolled conventional group. Results: All patients in both group were successfully completed surgery, postoperative recovery was good. No complication such as postoperative bleeding, recurrent laryngeal nerve or superior laryngeal nerve or parathyroid injury. Bleeding volume and postoperative drainage of two groups had no significantl difference. The operation time in endoscopic group was significantly longer than that in conventional group (P<0.05). The bleeding volume in endoscopic group was significantly less than that in conventional group (P<0.05). The time spans of recovery to independently walking and washing in endoscopic group were significantly shorter than that in conventional group(P<0.05). The cost of hospitalization in endoscopic group was significantly higher than that in conventional group (P<0.05). The postoperative cosmetic satisfaction in endoscopic group was significantly higher than that in conventional group (P<0.05). Conclusion: Compared with conventional thyoidectomy, breast approach endoscopy offers quicker functional recovery and higher cosmetic satisfaction with less postoperative pain.

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