摘要
目的:观察一侧甲状腺全切加对侧次全切除术(Dunhill)治疗甲状腺微小乳头状癌(PTMC)患者的效果。方法:选取2019年1月至2021年6月邓州市罗庄镇卫生院和邓州市人民医院联合收治的95例PTMC患者进行前瞻性研究,以随机数字表法将其分为对照组45例和观察组50例。对照组接受甲状腺全切术治疗,观察组接受Dunhill术治疗,比较两组围术期指标(手术时间、术中出血量、住院时间)水平、术后3个月恢复情况[反流症状指数量表(RSI)评分、嗓音障碍指数量表(VHI)评分]、临床疗效、复发情况和术后1个月并发症发生率。结果:观察组手术时间和住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组VHI、RSI评分比较,差异均无统计学意义(P>0.05);观察组治疗总有效率为98.00%(49/50),高于对照组的84.44%(38/45),差异有统计学意义(P<0.05);随访1年,观察组复发率高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为16.00%(8/50),低于对照组的42.22%(19/45),差异有统计学意义(P<0.05)。结论:Dunhill术治疗PTMC患者能提高临床疗效,减少术后并发症发生率和术中出血量,缩短手术时间和住院时间,但会增加复发率。
Objective:To observe effects of unilateral total thyroidectomy plus contralateral subtotal thyroidectomy(Dunhill)in treatment of patients with papillary thyroid microcarcinoma(PTMC).Methods:95 patients with PTMC admitted to Dengzhou People’s hospital from January 2019 to June 2021 were selected for the prospective study and were divided into control group(45 cases)and observation group(50 cases)by using the random number table method.The control group received total thyroidectomy,while the observation group was given the Dunhill surgery.The levels of the perioperative indicators[operation time,intraoperative blood loss,hospitalization time],the recovery status 3 months after the surgery[Reflux symptom index(RSI)score,voice impairment index(VHI)score],the clinical efficacy,the recurrence conditions,and 1 month postoperative complication rate were compared between the two groups.Results:The operation time and the hospitalization time in the observation group were shorter than those in the control group;the intraoperative blood loss was less than that in the control group;and the differences were statistically significant(P<0.05).There were no significant differences in the VHI and RSI scores between the two groups(P>0.05).The total effective rate of the observation group was 98.00%(49/50),which was higher than 84.44%(38/45)of the control group,and the difference was statistically significant(P<0.05).After 1-year follow-up,the recurrence rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Further,the incidence of complications in the observation group was 16.00%(8/50),which was lower than 42.22%(19/45)in the control group,and the difference was statistically significant(P<0.05).Conclusions:The Dunhill surgery has a significant effect in the treatment of the PTMC patients,which can improve the clinical efficacy and reduce the incidence of postoperative complications,but it will increase the recurrence rate.
作者
韩明相
郑德泉
HAN Mingxiang;ZHENG Dequan(Department of General Surgery of Luozhuang Town Health Center of Dengzhou City,Dengzhou 474184 Henan,China;Department of Thyroid and Breast Surgery of Dengzhou People’s Hospital,Dengzhou 474150 Henan,China)
出处
《中国民康医学》
2022年第14期37-40,共4页
Medical Journal of Chinese People’s Health
关键词
一侧甲状腺全切加对侧次全切除术
甲状腺全切术
甲状腺微小乳头状癌
复发
并发症
Unilateral total thyroidectomy plus contralateral subtotal thyroidectomy
Total thyroidectomy
Thyroid micropapillary carcinoma
Recurrence
Complication
