摘要
目的分析经颈部入路微创腔镜手术治疗甲状腺微小癌(TMC)的临床效果。方法抽取2020年6月至2022年5月河南科技大学第一附属医院收治的TMC患者98例,按照随机数字表法分为常规组和微创组,每组49例。常规组采用常规手术治疗,微创组采用经颈部入路微创腔镜手术治疗。比较两组患者的手术指标、术后指标、术后疼痛程度[视觉模拟评分法(VAS)评分]、甲状腺激素[促甲状腺激素(TSH)、游离三碘甲状腺原氨(FT3)、游离甲状腺素(FT4)]水平及并发症发生率。结果微创组手术时间长于常规组,切口长度短于常规组,术中出血量少于常规组(P<0.05)。微创组术后引流量少于常规组,拔管时间、住院时间短于常规组(P<0.05)。微创组术后6、12、24 h的VAS评分均低于常规组(P均<0.05)。术后3 d,微创组TSH、FT3水平低于常规组,FT4水平高于常规组(P<0.05)。微创组并发症发生率(4.08%,2/49)低于常规组(18.37%,9/49),P<0.05。结论经颈部入路微创腔镜手术治疗TMC效果较好,可改善患者围术期情况,减轻机体疼痛,改善甲状腺激素水平,且术后并发症发生风险较小。
Objective To analyze the effect of minimally invasive endoscopic surgery through cervical approach in the treatment of thyroid microcarcinoma(TMC).Methods A total of 98 patients with TMC treated in the First Affiliated Hospital of Henan University of Science and Technology from June 2020 to May 2022 were selected,and they were divided into conventional group and minimally invasive group according to random number table method,with 49 cases in each group.The conventional group was treated by conventional surgery,and the minimally invasive group was treated by minimally invasive endoscopic surgery through cervical approach.The surgical indexes,postoperative indexes,postoperative pain level assessed by visual analogue scale(VAS),levels of thyroid hormones,including thyroid hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4),and the incidence of complications were compared between the two groups.Results Compared with the conventional group,the minimally invasive group had longer operation time,shorter incision length,and less intraoperative blood loss(P<0.05).The postoperative drainage volume in the minimally invasive group was less than that in the conventional group,while the extubation time and hospital stay were shorter than those in the conventional group(P<0.05).The VAS scores in the minimally invasive group were lower than those in the conventional group at 6,12 and 24 hours after operation(all P<0.05).The levels of TSH and FT3 in the minimally invasive group were lower than those in the conventional group,and the level of FT4 was higher than that in the conventional group 3 days after surgery(P<0.05).The incidence of complications in the minimally invasive group was 4.08%(2/49),lower than the 18.37%(9/49)in the conventional group(P<0.05).Conclusions Minimally invasive endoscopic surgery through cervical approach is effective in the treatment of TMC,which can improve perioperative conditions,relieve body pain,improve thyroid hormone levels,and reduce the risk of postoperative complications.
作者
侯永强
王新征
柳笛
Hou Yongqiang;Wang Xinzheng;Liu Di(Department of Thyroid Surgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)
出处
《中国实用医刊》
2023年第22期5-8,共4页
Chinese Journal of Practical Medicine
关键词
甲状腺癌
经颈部入路
微创腔镜手术
Thyroid neoplasms
Cervical approach
Minimally invasive endoscopic surgery
