简易气管造瘘术对喉癌及下咽癌患者术中出血量及术后血清促甲状腺素、转化生长因子-β1水平变化的影响  

Effects of simple tracheostomy on intraoperative blood loss and serum TSH and TGF-β1 levels in patients with laryngeal and hypopharyngeal carcinoma

作　　者：司远征[1] 马赛[1] 马振亚[1] 

机构地区：[1]南阳医学高等专科学校第一附属医院耳鼻喉头颈外科,河南省南阳市473000

出　　处：《中国临床实用医学》2017年第6期32-36,共5页China Clinical Practical Medicine

摘　　要：目的探讨简易气管造瘘术对喉癌及下咽癌患者的治疗效果，及对血清促甲状腺激素（TSH）与转化生长因子-β1（TGF-β1）水平的影响。方法选取2014年7月至2016年12月南阳医学高等专科学校第一附属医院耳鼻喉头颈外科收治的92例喉癌及下咽癌患者，根据术式不同分为对照组和观察组，每组46例。对照组行常规气管切开术，观察组行简易气管造瘘术。比较两组患者的手术时间、术中出血量及住院时间，手术前后血清TSH、TGF-β1水平的变化，术后并发症的发生情况，以及手术前后的生存质量评分。结论观察组患者的手术时间短、术中出血量少、住院时间短，与对照组比较，差异有统计学意义（P〈0．05）。两组患者术前血清TSH、TGF-β1水平比较，差异无统计学意义（P〉0．05）；术后观察组患者的TSH水平高于对照组，TGF-β1水平低于对照组，差异有统计学意义（P〈0．05）。观察组患者术后并发症的发生率低于对照组，差异有统计学意义（P〈0．05）。两组患者术前的生存质量评分比较，差异无统计学意义（P〉0．05）；术后3个月，观察组患者的生存质量评分高于对照组，差异有统计学意义（P〈0．05）。结果简易气管造瘘术可有效减少喉癌及下咽癌患者的术中出血量，降低患者的血清TGF-β1水平，且对血清TSH水平影响较小，并发症少，对改善患者术后的生存质量具有重要意义。Objective To investigate the effect of simple traeheostomy on intraoperative blood loss and postoperative serum thyrotropin（TSH）and transforming growth factor-β1 （TGF-β1）in patients with laryngeal and hypopharyngeal carcinoma. Methods A retrospective study was performed on 92 cases of patients with laryngeal and hypopharyngeal carcinoma who were admitted from July 2014 to December 2016. According to different procedures, patients were divided into the normal group and the observation group, with 46 cases in each group. Patients in the normal group underwent conventional traeheotomy, the others underwent simple tracheostomy. The operation time, intraoperative bleeding, hospital stay, level changes of TSH and TGF-β1, complications, quality of life before and after surgery were evaluated between the two groups. Results Compared with the normal group, the operation time was shorter, intraoperative bleeding was less, hospital stay was shorter in the observation group （ P 〈 0. 05 ）. There was no significant difference in the TSH and TGF-β1 levels between the two groups before operation （P 〉 0. 05 ） ;after operation, the TSH level in the observation group was significantly higher than that in the normal group ,and the TGF-β1 level was significantly lower than that in the normal group （ P 〈 0. 05 ） ; The incidence of postoperative complications in the observation group was lower than that of the normal group, （P 〈 0. 05） ; there was no significant difference in the quality of life score between the two groups before operation （ P 〉 0. 05 ）, after operation, the quality of life score in the observation group was significantly higher than that in the normal group （ P 〈 0. 05 ）. Conclusion Simple tracheostomy can effectively reduce the intraoperative bleeding and reduce the serum TGF-β1 level in patients with laryngeal and hypopharyngeal carcinoma, and it has slight effect on the serum TSH level and less complication,which is of great importance to improve the quality of lif

关 键 词：喉癌 下咽癌 简易气管造瘘术 术中出血量 促甲状腺激素 转化生长因子-Β1 

分 类 号：R73[医药卫生—肿瘤]