甲状腺癌普外切除术中腔镜技术的选取及应激反应分析  

Analysis of laparoscopic technique selection and stress response during the radical resection of thyroid cancer

作　　者：邢颖[1] 真德智 冯国勋[1] Xing Ying;Zhen Dezhi;Feng Guoxun(Department of general surgery,Beijing Tiantan Hospital Bei Jing 100050)

机构地区：[1]北京天坛医院普外科,北京100050

出　　处：《中华普外科手术学杂志（电子版）》2018年第5期421-423,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨甲状腺癌术中腔镜技术的选取及应激反应情况。方法选取2014年3月至2018年2月收治的126例甲状腺癌患者,随机分为A,B,C三组,各42例;3D腔镜切除术(A组)、2D腔镜切除术(B组)及开放术(C组)。数据处理应用统计学软件SPSS 22.0完成。本研究中术后并发症发生率采用χ2检验;手术相关指标、应激反应指标用(x±s)表示,比较采用单因素方差分析;P<0.05差异有统计学意义。结果 A组手术时间短于B组(P<0.05),长于C组(P<0.05);A组术中出血量低于B组、C组(均P<0.05);A组术后引流量低于B组(P<0.05),高于C组(P<0.05)。A、B、C三组患者术后并发症发生率分别为4.8%、11.9%、26.2%(P<0.05)。术后三组患者的BG、P、CRP含量均高于术前(均P<0.05),且A组<B组<C组(均P<0.05),A组患者术后应激反应最小。结论:3D腔镜术治疗甲状腺癌,可显著降低术中出血量及并发症发生率,安全性高,对机体刺激小,值得推广应用。Objective To explore the selection of laparoscopic techniques and the stress response during the radical resection of thyroid cancer. Methods 126 patients with thyroid cancer treated in our hospital from March 2014 to February 2018 were selected, and they were randomly divided into three groups： group A, group B, and group C, with 42 cases in each group, and they were given 3D laparoscopic resection , 2D laparoscopic resection and open surgery respectively. Data processing application statistics software SPSS22.0 was completed. In this study, the incidence of postoperative complications was compared by chi-square test, and the related indexes of operation and the index of stress response were indicated by （x±s） . The comparison of the three samples was compared with the single factor analysis of variance; P 〈0.05 was statistically significant. Results The operation time of group A was shorter than group B （ P〈0.05） , which was longer than group C （ P 〈0.05）. The blood volume of group A was lower than that of group B and C （ P〈0.05）, and the volume of drainage of group A was lower than that of group B （ P 〈0.05） . The incidence of postoperative complications in the three groups of A, B and C groups were 4.8%, 11.9% and 26.2% respectively. The difference was statistically significant （ P 〈0.05）. The incidence of complications in group A was lower than that of group C （ P 〈0.05）. The levels of BG, P and CRP in the three groups were higher than those before operation （all P 〈0.05）, and the group A〈group B〈 group C （ P 〈0.05）, the group A had the lowest stress response after operation. Conclusion 3D laparoscopic surgery for thyroid cancer can significantly reduce the amount of intraoperative blood loss and complication rates, the safety is high. The stimulation to the body is less than 2D laparoscopic and open surgery . The effect is significant and it is worthy of popularization and application.

关 键 词：甲状腺肿瘤 腹腔镜检查 手术后并发症 应激反应 

分 类 号：R736.1[医药卫生—肿瘤]