目的

对比不同手术空间建立方法的经口腔前庭入路腔镜甲状腺术（TOETVA）的应用效果。

方法

收集2020年6月至2023年6月接受TOETVA治疗的120例甲状腺疾病患者作为研究对象，并将入组患者按照随机数字表法随机分为A组和B组，每组各60例。A组采用常规法建立手术空间， B组则采用膨胀液水分离法建立手术空间。使用SPSS 22.0统计学软件进行分析数据，围手术期相关指标、SSA及VHI评分等计量资料采用（x ± s）表示，行独立样本t检验；术后并发症等计数资料采用［例（%）］表示，行χ²检验分析。P＜0.05表示差异有统计学意义。

结果

A组建腔时间明显低于B组，手术时间及术中出血量却明显高于B组（P＜0.05）；两组患者引流管拔除时间、术后住院时间及术后美观满意度比较，差异均无统计学意义（P＞0.05）。B组患者并发症总发生率较A组略低（15.0% vs.23.3%），但差异无统计学意义（P＞0.05）。术后1周、1个月B组患者VHI-10评分和SSA评分均明显低于A组（P＜0.05）。

结论

常规手术操作空间建立法虽步骤少、时间短，但膨胀液水分离法层次更清晰，可有效缩短手术时间，减少术中出血，更有利于保护喉返神经功能，更值得于临床推广。

Objective

To compare the effect of transvestibular approach endoscopic thyroid surgery（TOETVA） with different methods of space establishment.

Methods

A total of 120 patients with thyroid disease who received TOETVA treatment from June 2020 to June 2023 were collected as research objects， and the enrolled patients were randomly divided into group A and group B according to random number method，with 60 patients in each group.Surgical space was established in group A by conventional method， and in group B by dilatant liquid-water separation method.Statistical software SPSS 22.0 was used to analyze the data.Measurement data such as perioperative indicators， SSA and VHI scores were expressed by （x ± s）， and independent sample t test was performed.The statistical data of postoperative complications were expressed by［ cases （%）］ and analyzed by χ² test.P＜0.05 indicated that the difference was statistically significant.

Results

The time of lumen formation in group A was significantly lower than that in group B， but the operative time and intraoperative blood loss were significantly higher than those in group B （P＜0.05）.There were no significant differences in drainage tube removal time， postoperative hospitalization time and postoperative aesthetic satisfaction between the two groups （P＞0.05）.The total incidence of complications in group B was slightly lower than that in group A （15.0% vs.23.3%）， but the difference was not statistically significant （P＞0.05）.The VHI-10 score and SSA score of group B were significantly lower than those of group A at 1 week and 1 month after surgery （P＜0.05）.

Conclusion

Although the conventional operation space establishment method has few steps and short time， the dilatation liquid water separation method has a clearer level， can effectively shorten the operation time， reduce intraoperative bleeding， and is more conducive to protecting the function of recurrent laryngeal nerve， and is worthy of clinical promotion.