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摘要: 目的 探讨三维可视化技术在腔镜甲状腺手术中的应用价值。方法 将术前细针穿刺明确为甲状腺乳头状癌的50例患者随机分为联合组(20例)和单纯手术组(30例)，联合组采用腔镜甲状腺手术联合三维可视化模型制作，单纯手术组采用单纯腔镜甲状腺手术。比较两组术前与患者的沟通时间及沟通满意度、术中出血量及手术时间、术后并发症等指标。结果 联合组和单纯手术组术前与患者的沟通时间分别为(23.05±6.83) min和(28.83±8.57) min，联合组沟通时间更短，沟通交流后患者对病情知晓满意度更高，两组比较差异有统计学意义(P＜0.05)。联合组和单纯手术组的手术时间分别为(104.30±13.06) min和(130.46±17.01) min，联合组手术时间更短(P＜0.05)；术中出血量分别为(12.80±6.10) mL和(17.60±5.19) mL，联合组术中出血量更少(P＜0.05)。两组在术后并发症方面的差异无统计学意义(P＞0.05)。结论 三维可视化模型的重建有助于改善医患沟通，提高腔镜甲状腺手术的安全性，加快患者术后康复，值得推广。Abstract: Objective To explore the application value of three dimensional(3D) visualization in the endoscopic thyroidectomy.Methods Fifty patients with thyroid papillary carcinoma confirmed by preoperative fine needle aspiration(FNA) were randomly divided into the combined group (20 cases) and the simple operation group (30 cases). Endoscopic thyroid surgery combined with three-dimensional visualization model was used in the combined group. Simple operation group was treated with simple endoscopic thyroid surgery. The communication time and communication satisfaction, intraoperative blood loss, operation time and postoperative complications between the two groups were compared.Results The communication time with patients in the combined group and the simple operation group before operation was (23.05±6.83) min and (28.83±8.57) min. The communication time in the combined group was shorter, and the patients' satisfaction with disease awareness was higher after communication. There was a statistically significant difference between the two groups (P < 0.05). The operation time of combined group and simple operation group was (104.30±13.06) min and (130.46±17.01) min respectively, and the operation time of combined group was shorter (P < 0.05). The intraoperative bleeding volume of combined group and simple operation group was (12.80±6.10) mL and (17.60±5.19) mL, and the combined group had less intraoperative bleeding volume (P < 0.05). There was no significant difference in postoperative complications between the two groups (P > 0.05).Conclusion 3D visualization technology will benefit to improve the efficiency of doctor-patient communication, enhance the safety of the endoscopic thyroidectomy, and then accelerate the postoperative rehabilitation of patients, which worthy of clinical promotion and practice.
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表 1 两组患者基本情况比较
组别 例数 年龄/岁 身高/cm 体重/kg 肿瘤长径/mm 联合组 20 33.40±6.83 164.15±5.99 53.90±7.49 6.92±2.93 单纯手术组 30 32.73±6.79 164.56±6.03 54.5±7.56 7.37±2.72 t值 0.339 -0.240 -0.276 -0.556 P值 0.736 0.811 0.784 0.580 95%CI -3.28~4.61 -3.90~3.07 -4.97~3.77 -2.08~1.17 
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