改良Miccoli术式与传统术式在甲状腺腺叶切除中的效果比较[摘要]目的比较改良Miccoli术式与传统术式在甲状腺腺叶切除中的效果。方法选取2014年6月～2017年6月辽宁省抚顺市中心医院收治144例甲状腺良性疾病手术患者，依照随机数字表法分成对照组和观察组，每组各72例，观察组采用Miccoli术，对照组采用传统术式。对两组患者对两组患者手术指标、以及术后3d疼痛VAS评分和反流症状指数量表评分（RSI）、术后3个月声音障碍程度（VHI）评分等进行比较。并对两组患者手术前后血钙、甲状旁腺素（PTH）和并发症发生率进行比较。结果观察组患者切口长度、手术时间和术中出血量均显著小于对照组，差异有高度统计学意义（P<0.01）；观察组术后引流量低于对照组，住院时间短于对照组，颈部活动恢复时间早于对照组，差异有高度统计学意义（P<0.01）。患者的术后3dVAS评分显著低于对照组，差异有高度统计学意义（P<0.01）；RSI评分和术后3个月VHI评分比较，差异无统计学意义（P>0.05）。术后3d，?^察组患者血钙和PTH水平显著高于对照组，差异有高度统计学意义（P<0.01）。观察组患者不良反应发生率显著低于对照组，差异有高度统计学意义（P<0.01）。结论改良Miccoli术应用于甲状腺腺叶切除治疗较传统术式疗效显著，具有创伤小、恢复快、美观等优点，更有助于维持血钙和PTH的稳定，不良反应较少，值得临床推广。[关键词]甲状腺腺叶切除；改良Miccoli术式；传统术式；甲状旁腺素[]R736.1[文献标识码]A[]1673-7210（2018）04（b）-0131-04[Abstract]ObjectiveTocomparetheeffectofmodifiedMiccoliandtraditionalopensurgeryinthetreatmentofthyroidglandlobectomy.MethodsFromJune2014toJune2017，inFushunCentralHospital，144patientswithbenignthyroiddiseaseswereselected，theyweredividedintocontrolgroupandobservationgroup，with72casesineachgroup，accordingtotherandomnumbertablemethod，observationgroupwasgivenmodifiedMiccolisurgery，controlgroupwasgiventraditionalsurgery.Thesurgicalindexessuchasthelengthofincision，thetimeofoperation，thesurgicalindexs，VASandRSIscorespostoperative3days，VHIscorepostoperativeof3monthsandcosmeticeffectintwogroupswerecompared，andtheincidenceofbloodcalcium，parathyroidhormone（PTH）beforeandafteroperationandtheincidenceofcomplicationsintwogroupswerecompared.ResultsThepostoperativedrainagevolumeinobservationgroupwaslowerthancontrolgroup，thehospitalizationtimewasshorterthancontrolgroup，andtherecoverytimeofcervicalmovementwasearlierthancontrolgroup，thedifferenceswerestatisticallysignificant（P<0.01）；comparedwithcontrolgroup，thepatientsinobservationgrouphadlessflowrate，shorterhospitalizationtimeandfasterrecoverytimeintheneck，thedifferenceswerestatisticallysignificant（P<0.01）.After3daysofoperation，theVASscoreobservationgroupwassignificantlylowerthancontrolgroup，thedifferencewasstatisticallysignificant（P<0.01）.ButtherewasnosignificantdifferenceinRSIscoreandVHIscorebetweentwogroupsaftertheoperation3months.After3daysofoperation，thelevelofbloodcalciumandPTHinobservationgroupwassignificantlyhigherthancontrolgroup，thedifferenceswerestatisticallysignificant（P<0.01）.Theincidenceofadversereactionsinobservationgroupwassignificantlylowerthancontrolgroup，thedifferenceswerestatisticallysignificant（P<0.01）.ConclusionModifiedMiccoliisbetterthantraditionaloperationinthetreatmentofthyroidlobectomy.Ithastheadvantagesoflesstrauma，quickerrecoveryandbetterappearance.IthelpsmaintainthestabilityofbloodcalciumandPTH，andhasfewersideeffects.Itisworthyofclinicalpromotion.[Keywords]Thyroidglandlobectomy；ModifiedMiccolisurgery；Traditionalsurgery；Parathyroidhormone甲状腺疾病是临床上发生较多的一...