目的 比较经口联合颏下入路腔镜甲状腺手术与开放手术治疗甲状腺肿瘤的临床疗效。 方法 回顾性分析2021年1月至2022年6月在我院接受甲状腺肿瘤切除患者共154例，其中腔镜组74例采用经口联合颏下入路腔镜甲状腺切除术，开放组80例采用传统颈前开放术式，收集两组临床资料与随访资料并分析。 结果 所有手术顺利完成，腔镜组无中转开放，腔镜组与开放组相比，术中出血量（19.46 ± 10.24 vs. 32.05 ± 15.87）mL，切口长度（1.95 ± 0.30）cm vs. （7.05 ± 0.60）cm，手术时长（136.66 ± 22.44）min vs. （82.75 ± 15.20）min，术后总引流量（111.35 ± 38.92）mL vs. （95.45 ± 36.73）mL，差异有统计学意义（P < 0.05）。腔镜组患者术后疼痛、美容满意度，颈部感觉满意度等方面均优于开放组，差异有统计学意义（P < 0.05）。而两组在淋巴结清扫数量上、甲状旁腺素上、术后并发症等方面差别无统计学意义（P > 0.05）。 结论 经口联合颏下入路腔镜甲状腺手术与传统开放手术相比，临床疗效相当，且经口联合颏下入路腔镜甲状腺手术具有术中出血量少、术后疼痛较轻、颈部切口美容效果好等优点，值得临床推广运用。

Objective To compare endoscopic thyroidectomy via transoral submental approach with open surgery for treating thyroid tumors in terms of the clinical effectiveness. Methods We retrospectively reviewed and analyzed the clinical data and follow?up records of 154 patients in the study， who were hospitalized for thyroidectomy in our hospital from January 2021 to June 2022. Among them， 74 cases undergoing endoscopic thyroidectomy via transoral submental approach were assigned to the endoscopic group and 80 cases undergoing traditional open thyroid surgery to the open surgery group. Results All operations were completed successfully and safely in both groups， with no intermediate openings in the endoscopic group. Compared with the open surgery group， the endoscopic group had significantly fewer intraoperative blood losses ［（19.46 ± 10.24）mL vs. （32.05 ± 15.87）mL］， significantly less incision length ［（1.95 ± 0.30）cm vs. （7.05 ± 0.60）cm］， significant shorter operative time ［（136.66 ± 22.44）min vs. （82.75 ± 15.20）min］， and significantly less total postoperative drainage ［（111.35 ± 38.92）mL vs. （95.45 ± 36.73）mL］ （all P < 0.05）. Endoscopic patients had superior postoperative pain and cosmetic satisfaction compared to open patients， and the difference was statistically significant （P < 0.05）. The two groups had no significant differences in the number of lymph node dissections， parathyroid hormone， and postoperative morbidity between the two groups （P > 0.05）. Conclusion The endoscopic thyroidectomy via transoral submental approach can achieve the same clinical effectiveness as the traditional open surgery. However， it is advantageous in reducing intra?operative blood loss， relieving post?operative pain， and achieving a better cosmetic effects of neck incision， thus deserving clinical promotion and application.