目的探讨经口腔前庭入路腔镜甲状腺切除术(endoscopic thyroidectomy using the oral vestibular approach,ETOVA)与传统颈部开放手术治疗女性甲状腺乳头状癌的安全性、有效性及美容效果。方法回顾性分析2019年1~12月行甲状腺乳头状癌...目的探讨经口腔前庭入路腔镜甲状腺切除术(endoscopic thyroidectomy using the oral vestibular approach,ETOVA)与传统颈部开放手术治疗女性甲状腺乳头状癌的安全性、有效性及美容效果。方法回顾性分析2019年1~12月行甲状腺乳头状癌根治术的120例女性患者的临床资料,分为经口腔前庭入路腔镜甲状腺手术组(腔镜组,n=60)和传统颈部开放手术组(开放组,n=60),对比两组患者术中及术后相关临床资料。结果两组患者年龄、肿瘤直径、中央区淋巴结清扫时间、中央区淋巴结清扫总数、中央区转移淋巴结数量、术后并发症、术后24 h疼痛评分、术后6个月疼痛评分均无统计学差异(P均>0.05)腔镜组手术总时长、术中失血量、术后引流量均大于开放组(P均<0.001),腔镜组术后满意度高。结论ETOVA在治疗甲状腺乳头状癌是安全、有效的,具有更好的美容效果,患者满意度高,可以考虑作为部分患者,尤其是年轻女性甲状腺乳头状癌患者的首选手术方案。展开更多
This study was designed to compare the approaches and efficacies of two different ways of neurosurgical management for spontaneous putaminal hemorrhage(SPH):computed tomographic-guided aspiration(CTGA)and the key-hole...This study was designed to compare the approaches and efficacies of two different ways of neurosurgical management for spontaneous putaminal hemorrhage(SPH):computed tomographic-guided aspiration(CTGA)and the key-hole approach(KHA).The indications of the two approaches are also explored.From September 2001 to 2003,a total of 1077 cases of SPH distributed in 135 hospitals all over the mainland of China were included for analysis.All cases had three-month follow-up data.The study was designed in a single-blinded manner to compare the efficacies of the different approaches.There were 563 cases in the CTGA group,165 in the KHA group,and 217 cases in the conventional open craniotomy(COC)group.In the CTGA and KHA groups,the mortalities at one month after operation(M1m)were 17.9% and 18.3%,respectively,while the mortalities at three months after operation(M3m)were 19.4% and 19.4%,respectively(P>0.05).The postoperative complications due to CTGA(23.7%)were not significantly different from those due to KHA(25.7%)(P=0.420).The M3m of patients with Glasgow coma scale(GCS)h8 was 3.45 and 4.0 times as much as those with GCS>8,respectively.The M3m of patients with complications was 3.92 times as much as those without complications.The M3m of patients with hemorrhage volume ≥70 mL was 2.67 times as much as those<70 mL.The CTGA is not better than KHA in the treatment of SPH in terms of a more favorable outcome or less mor tality and morbidity,but CTGA could be the first choice for those with bleeding volumes ≤50mL,while KHA is the first choice for those with bleeding volumes>50 mL.展开更多
文摘目的探讨经口腔前庭入路腔镜甲状腺切除术(endoscopic thyroidectomy using the oral vestibular approach,ETOVA)与传统颈部开放手术治疗女性甲状腺乳头状癌的安全性、有效性及美容效果。方法回顾性分析2019年1~12月行甲状腺乳头状癌根治术的120例女性患者的临床资料,分为经口腔前庭入路腔镜甲状腺手术组(腔镜组,n=60)和传统颈部开放手术组(开放组,n=60),对比两组患者术中及术后相关临床资料。结果两组患者年龄、肿瘤直径、中央区淋巴结清扫时间、中央区淋巴结清扫总数、中央区转移淋巴结数量、术后并发症、术后24 h疼痛评分、术后6个月疼痛评分均无统计学差异(P均>0.05)腔镜组手术总时长、术中失血量、术后引流量均大于开放组(P均<0.001),腔镜组术后满意度高。结论ETOVA在治疗甲状腺乳头状癌是安全、有效的,具有更好的美容效果,患者满意度高,可以考虑作为部分患者,尤其是年轻女性甲状腺乳头状癌患者的首选手术方案。
文摘This study was designed to compare the approaches and efficacies of two different ways of neurosurgical management for spontaneous putaminal hemorrhage(SPH):computed tomographic-guided aspiration(CTGA)and the key-hole approach(KHA).The indications of the two approaches are also explored.From September 2001 to 2003,a total of 1077 cases of SPH distributed in 135 hospitals all over the mainland of China were included for analysis.All cases had three-month follow-up data.The study was designed in a single-blinded manner to compare the efficacies of the different approaches.There were 563 cases in the CTGA group,165 in the KHA group,and 217 cases in the conventional open craniotomy(COC)group.In the CTGA and KHA groups,the mortalities at one month after operation(M1m)were 17.9% and 18.3%,respectively,while the mortalities at three months after operation(M3m)were 19.4% and 19.4%,respectively(P>0.05).The postoperative complications due to CTGA(23.7%)were not significantly different from those due to KHA(25.7%)(P=0.420).The M3m of patients with Glasgow coma scale(GCS)h8 was 3.45 and 4.0 times as much as those with GCS>8,respectively.The M3m of patients with complications was 3.92 times as much as those without complications.The M3m of patients with hemorrhage volume ≥70 mL was 2.67 times as much as those<70 mL.The CTGA is not better than KHA in the treatment of SPH in terms of a more favorable outcome or less mor tality and morbidity,but CTGA could be the first choice for those with bleeding volumes ≤50mL,while KHA is the first choice for those with bleeding volumes>50 mL.
