目的对比探讨全乳晕入路与胸乳入路腔镜双侧甲状腺手术的临床疗效。方法将2010年3月至2012年8月入住成都市第五人民医院的120例双侧甲状腺良性病变患者随机均分为对照组与观察组，对照组（n＝60）行胸乳入路腔镜双侧甲状腺术，观察组（n＝60）则采用全乳晕入路。对比两组患者的临床指标、临床疗效、术后生活质量及并发症发生率。结果（1）观察组患者的切口长度、失血量、手术时间、住院时间等均优于对照组（P＜0．05）；（2）对照组治疗总有效率（83．3％，50/60）明显低于观察组治疗总有效率（96．7％，58/60）（ P＜0．05）；（3）根据生活质量评估标准，对照组患者治疗后的生活质量得分为（102±7）分，低于观察组患者[（131±8）分，P＜0．05]；（4）术后并发症为短暂性声音嘶哑、皮下气肿、尿失禁及胸前壁局部麻木，观察组敋中术后并发症发生率低于对照组（P＜0．05）。结论运用全乳晕入路行腔镜双侧甲状腺手术，其临床效果尤佳，可有效改善患者的临床指标，提高患者生活质量，值得在临床推广应用。%Objective To investigate the breast areola approach compared with chest and breasts approach en-doscopic bilateral thyroid operation clinical methods and curative effect .Methods From March 2010 to August 2012 , 120 cases of bilateral thyroid benign lesions were randomly divided into control group and observation group ,control group(n=60) recerived chest and breasts approach endoscopic bilateral thyroidectomy ,observation group(n=60) re-cerived breast areola approach .Clinical indices ,clinical efficacy ,postoperative life quality and the incidence of compli-cations were compared .Results (1) The observation group length of incision ,operation time ,blood loss ,hospital stay time were better than the control group(P<0 .05) .(2)The total effective rate in control group was 83 .3% (50/60) ,significantly lower than the observation group(96 .7% ,58/60 ,P<0 .05) .(3)According to the quality of life as-sessment criteria ,patients in the control group after treatment for quality of life score was (102 ± 7)points ,the pa-tients in the observation group was (131 ± 8)points(P< 0 .05 ) .(4)Postoperative complications were transient hoarseness ,subcutaneous emphysema ,urinary incontinence and anterior chest wall partial numbness ,observation group than those in control group (P>0 .05) .Conclusion The use of whole breast areola approach cavity mirror bi-lateral thyroid operation could effectively improve the clinical indices of the patients ,improve the quality of life of pa-tients ,should be generalized and applied in clinic .
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