改良Miccoli术式治疗甲状腺乳头状癌的临床效果及并发症探讨

摘要/Abstract

摘要： 目的探讨内镜辅助下经颈部小切口行甲状腺切除（改良Miccoli）术式治疗甲状腺乳头状癌的临床效果及对并发症的影响。方法选取2019年10月~2020年10月东营市第二人民医院收治的甲状腺乳头状癌患者64例,采用随机数表法分为对照组与观察组,每组32例。对照组应用常规开放性甲状腺乳头状癌切除术,观察组应用改良Miccoli术式。比较两组手术相关指标及并发症发生率。结果研究组患者手术时间长于对照组,差异有统计学意义（P<0.05）;研究组住院时间、切口长度均短于对照组,差异有统计学意义（P<0.05）;两组术中出血量比较,差异无统计学意义（P>0.05）;两组并发症总发生率比较,差异无统计学意义（P>0.05）。结论针对甲状腺乳头状癌患者运用改良Miccoli术式,疗效确切,且未增加并发症发生率。

关键词: 改良Miccoli术式, 甲状腺乳头状癌, 临床疗效, 并发症

Abstract: Objective To investigate the clinical effect of endoscopic-assisted thyroidectomy through small neck incision (modified Miccoli) in papillary thyroid carcinoma and its effect on complications. Methods From October 2019 to October 2020, 64 patients with papillary thyroid cancer who were admitted to the Second People's Hospital of Dongying City were selected and grouped by random number table method, and 32 patients in the control group were treated with conventional open papillary thyroid cancer resection,32 cases in the observation group were treated with the modified Miccoli procedure. The surgical indexes and complication rates of the two groups were observed. Results The operation time of the patients in the observation group was longer than that in the control group, with a statistical difference (P<0.05);the length of hospital stay and incision in the observation group were shorter than that in the control group, with a statistical difference (P<0.05); there was no statistical difference intraoperative bleeding between the two groups (P>0.05);there was no statistical difference in the complication rates between the two groups (P>0.05). Conclusion For the clinically treated patients with papillary thyroid carcinoma, the modified Miccoli operation is effective in the treatment process, and there was no increase in the complication rates.

Key words: modified Miccoli procedure, papillary thyroid carcinoma, clinical efficacy, complications

中图分类号:

R653

魏强. 改良Miccoli术式治疗甲状腺乳头状癌的临床效果及并发症探讨[J]. 中华养生保健, 2022, 40(20): 48-50.

WEI Qiang. The Clinical Effect and Complications of Modified Miccoli Operation in the Treatment of Papillary Thyroid Carcinoma[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(20): 48-50.

参考文献

[1] 吴全生. 改良Miccoli术式治疗甲状腺乳头状癌的临床疗效观察[J].临床研究,2020,28(10):11-13.
[2] 孙达欣,宋景双,唐巍,等.改良Miccoli术式治疗甲状腺乳头状癌的临床疗效[J].重庆医学,2019,48(13):2217-2219.
[3] 中华医学会内分泌学分会,中华医学会外科学分会内分泌学组,中国抗癌协会头颈部肿瘤专业委员会,等.甲状腺结节和分化型甲状腺癌诊治指南[J].中华内分泌代谢杂志,2012,28(10):779-797.
[4] 袁牧,管晓青,吴骥.改良Miccoli术与经乳晕入路腔镜甲状腺手术治疗早期分化型甲状腺癌的临床疗效以及并发症分析[J].临床外科杂志,2020,28(10):53-56.
[5] 中华医学会内分泌学分会,中华医学会外科学分会,中国抗癌协会头颈肿瘤专业委员会.甲状腺结节和分化型甲状腺癌诊治指南[J].中国肿瘤临床,2012,39(17):1249-1272.
[6] 顾大力,沈祥.改良Miccoli微创甲状腺手术治疗甲状腺癌的临床研究[J].医学临床研究,2018,9(11):15-16.
[7] 石刚,董明,任宇鹏,等.改良Miccoli术式与完全内镜术式治疗良性甲状腺结节的临床分析[J].中国普通外科杂志,2019,23(5):643-643.
[8] 黄金朗,翁懿晖,张恒玮,等.甲状腺乳头状癌的临床诊治进展[J].中国临床研究,2020,33(2):108-110.
[9] 沈祥,缪志明,陆伟,等.改良Miccoli式完全内镜甲状腺癌根治术36例[J].中国现代普通外科进展,2019,14(11):906-909.
[10] 于学智,付荣湛.甲状腺癌外科治疗术式的探讨[J].普外临床,2019,7(6):336-337.
[11] 李婷,刘新梅,耿金秀.颈前小切口入路与改良Miccoli腔镜辅助下手术治疗甲状腺良性肿瘤的临床研究[J].中国医刊,2018,51(5):68-71.
[12] 于洋,高明.甲状腺微小乳头状癌外科治疗进展[J].中国肿瘤临床,2018,42(9):487-490.
[13] 蒋俊锋,蒋建刚,周苏君.纳米炭示踪与改良Miccoli技术在甲状腺乳头状癌全甲状腺切除术中的应用及比较[J].中国普通外科杂志, 2018,27(11):1393-1401.
[14] Gagner M.Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism[J]. Br J surg,1996,83(6):875.
[15] Miccoli P, Cecchini C, Conte M, et al.Minimally invasive, videoassisted parathyroid surgery for primary hyperparathyroidism[J]. J Endocrinol Invest,1997,20(7):429-430.
[16] 高力. Miccoli内镜术式与甲状腺手术操作的微创化[J].中华外科杂志,2006,44(1):10-13.
[17] 连书现. 改良Miccoli术治疗甲状腺微小乳头状癌效果分析[J].河南外科学杂志,2022,28(1):51-54.
[18] 汤承辉,李学庆.纳米碳在改良Micolli术式治疗甲状腺乳头状癌中的临床应用[J].中国临床医生杂志,2018,46(7):821-823.
[19] 覃丰毅,游波.改良Miccoli手术治疗cN0期甲状腺乳头状癌的临床研究[J].微创医学,2021,16(2):200-203.