目的 探讨双侧乳晕入路腔镜下治疗良性甲状腺疾病的手术效果和优势。方法 选取在我院行双侧乳晕入路腔镜甲状腺切除术患者165例为观察组, 另选行传统开放手术甲状腺切除术患者162例为对照组。比较两组手术时间、术中出血量、术后血清IL-6和TNF-α水平、术后并发症、患者对美容效果满意度等。结果 观察组术中出血量少于对照组[(50.3±10.4) vs (100.7±20.6) ml], 术后IL-6 [(21.45±1.42)pg/ml vs(36.36± l.45)pg/ml]和TNF-α[(26.58±1.62)pg/ml vs (35.51±1.53)pg/ml] 水平明显低于对照组, 差异有统计学意义(P＜0.05)。观察组患者术后美容效果满意度(8.9±0.8)高于对照组(4.2±0.4), 差异均有统计学意义(P＜0.05)。结论 双侧乳晕入路腔镜下甲状腺手术术中出血量较少, 创伤小, 美容效果优于开放手术, 值得推广。

Objective To study the clinical efficacy of endoscopic thyroidectomy through bilateral mammary areola for benign thyroid disease. Methods From January 2010 to January 2012, 165 patients with benign thyroid disease were recruited as subjects of the observation group, and from January 2009 to December 2009, 162 patients who underwent traditional open surgery were recruited as subjects of the control group.The clinical efficacy in the two groups was compared. Results The operation time in the observation group was longer than that in the control group, the difference was not statistically significant (P>0.05). The blood loss in the observation group (50.3±10.4) ml was less than that in the control group (100.7± 20.6) ml; the difference was statistically significant (P<0.05). The levels of postoperative IL-6 (21.45±1.42) pg/ml and TNF-α (26.58±1.62) pg/ml in the observation group were significantly lower than those in the control group (36.36±1.45, 35.51±1.53). The cosmetic effect satisfaction in observation group (8.9±0.8) was higher than that in the control group (4.2±0.4); the difference was statistically significant (P<0.05). Conclusions In the endoscopic thyroidectomy through bilateral mammary areola, the blood loss is less, the rate of postoperative complication is lower, especially the cosmetic effect satisfaction is better than in open surgery; so endoscopic thyroidectomy through anterior chest wall is worthy to be popularized.