目的　对甲状腺微小癌患者分别采用腔镜下与开放性手术治疗,对比腔镜下与开放性手术治疗的疗效。方法　选取2022年1月—2024年6月行甲状腺微小癌手术的82例患者,按随机数字表法分为对照组（41例,开放手术治疗）和观察组（41例,经胸乳入路腔镜甲状腺切除术治疗）,对比组间的手术相关指标（手术时间、术中出血量、中央区淋巴结节清扫数目）、治疗效果及安全性等。结果　观察组患者手术时间、中央区淋巴结节清扫数目多于对照组,术中出血量少于对照组,差异均有统计学意义（P<0.05）。两组患者治疗前免疫功能指标（CD3⁺、CD4⁺、CD8⁺、CD4⁺/ CD8⁺）对比,差异均无统计学意义（P>0.05）,治疗后观察组患者CD8⁺水平较对照组明显降低,其余免疫功能指标水平较对照组明显升高（P<0.05）。观察组治疗后患者和观测者瘢痕评价量表（POSAS）评分和观测者瘢痕评价量表（OSAS）评分显著高于对照组（P<0.05）。观察组患者术后并发症发生率显著低于对照组（P<0.05）。结论　与开放手术治疗比较,对甲状腺微小癌手术患者施行经胸乳入路腔镜甲状腺手术治疗,能够改善患者的手术指标和免疫功能,降低患者疼痛程度,优化其瘢痕评分,减少并发症的发生,值得临床推广。

Objective To compare the therapeutic effects of endoscopic and open surgical treatments for patients with thyroid microcarcinoma. Methods A total of 82 patients who underwent thyroid microcarcinoma surgery from January 2022 to June 2024 were selected and randomly divided into two groups by random number table method. The control group （41 cases） received open surgery treatment, while the observation group （41 cases） underwent thyroid surgery through the transthoracic approach using laparoscopic techniques. The surgical indicators （operative time, intraoperative blood loss, and number of central lymph nodes dissection）, treatment effects, and safety between the two groups were compared. Results The operative time and number of central lymph nodes dissection of the observation group were higher than those of the control group, while the intraoperative blood loss was less （P<0.05）. There was no statistically significant difference in immune function indicators （CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺） between the two groups before treatment （P>0.05）. However, after treatment, the CD8⁺ was lower and the other immune function indicators were higher in the observation group than those in the control group （P<0.05）. The scores of Patient and Observer Scar Assessment Scale （POSAS） and Observer Scar Assessment Scale （OSAS） in the observation group were higher than those in the control group after treatment （P<0.05）. Additionally, the incidence of postoperative complications in the observation group was lower than that in the control group （P<0.05）. Conclusion Compared with open surgery, transthoracic endoscopic thyroid surgery for patients with thyroid microcarcinoma could improve surgical indicators and immune function, alleviate pain, optimize scar scores, and reduce the occurrence of complications. This approach merits further clinical promotion.