【摘要】 目的 分析经口入路和乳晕入路腔镜手术对甲状腺恶性病变患者术后美观度满意度及生活质量的影响，为甲状腺疾病患者寻求更加有效且安全美观的手术治疗方式。方法 选取2022年1月至2023年3月甲状腺恶性病变手术患者120例，按照手术入路将患者分为经口腔前庭组55例和经乳晕组65例，经口腔前庭组采用经口腔前庭入路腔镜手术治疗，经乳晕组采取乳晕入路腔镜手术方法，对比2组患者的手术相关指标、美观满意度以及治疗后生活质量水平和术后并发症发生情况。结果 2组患者手术时间、住院时间以及术后SIS评分和VHI评分差异无统计学意义(P>0.05),经口腔前庭组的手术出血量及术后引流量低于经乳晕组，且经口腔前庭组术后VAS评分显著低于经乳晕组(P<0.05);经口腔前庭组的VSS、OSAS和PSAS评分均较经乳晕组低，其美观满意度较高(P<0.05);经口腔前庭组的治疗后SF-36各维度评分均较经乳晕组高(P<0.05);2组并发症发生率差异无统计学意义(P>0.05)。结论 甲状腺恶性病变患者手术治疗中，经口腔前庭入路腔镜手术治疗相较于经乳晕入路治疗方式更具安全性，患者术中损伤及术后疼痛均较为轻微，且无瘢痕美观性更强，有助于促进患者身心状态和生活质量提升，属于安全且有效的手术治疗方法。更多还原

【Abstract】 Objective To compare and analyze the effects of endoscopic surgery through oral approach versus areola approach on postoperative aesthetic satisfaction and quality of life in patients with thyroid malignant lesions, thus providing a more effective, safe and aesthetic surgical treatment for patients with thyroid diseases.Methods A total of 120 patients undergoing surgery for thyroid malignant lesions in the hospital from January 2022 to March 2023 were selected. They were divided into transoral vestibular group and transareolar group according to the surgical approach. In the transoral vestibular group, 55 patients underwent endoscopic surgery through oral vestibular approach; while in the transareolar group, 65 patients underwent endoscopic surgery through areola approach. The operation-related indexes, aesthetic satisfaction, quality of life after treatment and postoperative complications were compared between the two groups. Results There were no significant differences in operation time, length of stay, the Swallow Impairment Score(SIS) and the Voice Handicap Index(VHI) between the two groups(P>0.05). The intraoperative blood loss and postoperative drainage volume of the transoral vestibular group were significantly lower than those of the transareolar group, and the Visual Analogue Scale(VAS) score was significantly lower(P<0.05). The Vancouver Scar Scale(VSS), the Observer Scar Assessment Scale(OSAS) and the Patient Scar Assessment Scale(PSAS) scores of transoral vestibular group were significantly lower than those of transareolar group, and aesthetic satisfaction was significantly higher(P<0.05). The scores of all dimensions in the 36-Item Short Form Survey(SF-36) were significantly higher in the transoral vestibular group than those of the transareolar group(P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion In the surgical treatment of malignant thyroid diseases, endoscopic surgery through oral vestibular approach is safer than that through areola approach, presenting less intraoperative injury and postoperative pain, no scar and high aesthetic satisfaction, which is helpful to promote the improvement of physical and mental state and quality of life. It is a safe and effective surgical treatment.更多还原