考虑患者美学需求的乳晕入路腔镜甲状腺癌根治术疗效观察  

Observation on the Curative Effect of Endoscopic Radical Thyroidectomy Through Areola Approach Considering the Aesthetic Needs of Patients

作　　者：车红缨 兰浩淼[1] 邓巧莲[1] 张立 CHE Hong-ying;LAN Hao-miao;DENG Qiao-lian;ZHANG Li(Department of Thoracic and Breast Surgery,the First People's Hospital of Zigong,Zigong 643000,Sichuan,China)

机构地区：[1]自贡市第一人民医院甲乳外科,四川自贡643000

出　　处：《中国美容医学》2021年第8期28-31,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨完全乳晕入路腔镜甲状腺手术治疗甲状腺癌的疗效及对美观度的影响。方法:选取笔者医院2016年3月-2020年7月收治的66例甲状腺癌患者作为研究对象,根据手术方式的不同将其分对照组(n=36)、观察组(n=30),对照组采取传统开放性甲状腺癌根治术,观察组采取完全乳晕入路腔镜甲状腺癌根治术,比较两组患者血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)和甲状腺球蛋白(Tg)水平、围手术期指标(手术时间、术中出血量、住院时间、淋巴结清扫数目、住院费用和术后总引流量)、患者术后美容效果满意度和并发症发生情况。结果:与术前比较,术后24h两组患者VEGF和Tg水平均有所下降,TNF-α和CRP水平均有所上升,术后24h观察组VEGF、TNF-α、CRP和Tg水平明显低于对照组,差异有统计学意义(P<0.05)。两组清扫淋巴结数目比较差异无统计学意义(P>0.05);对照组手术时间和住院时间长于观察组,术中出血量多于观察组,住院费用和术后总引流量少于观察组,差异有统计学意义(P<0.05)。对照组总满意度为27.78%,明显低于观察组的86.67%,差异具有统计学意义(P<0.05)。对照组总并发症发生率为22.22%高于观察组的13.33%,组间比较差异无统计学意义(P>0.05)。结论:完全乳晕入路腔镜甲状腺手术治疗甲状腺癌患者临床疗效更为显著,VEGF、TNF-α、CRP和Tg水平明显被抑制,术后美容效果满意度良好,手术时间和住院时间短,术中出血量少,安全有效。Objective To investigate the effect of endoscopic thyroid surgery through complete areola approach in the treatment of thyroid cancer and its effect on aesthetics.Methods Sixty-six patients with thyroid cancer treated in our hospital from March 2016 to July 2020 were selected as the research objects.They were divided into the control group(n=36)and the observation group(n=30).The control group was treated with traditional open radical thyroidectomy.The observation group underwent complete areola laparoscopic radical thyroid cancer radical surgery.VEGF,TNF-α,CRP and TG levels,perioperative indicators(operation time,intraoperative bleeding,length of hospital stay,number of lymph node dissections,hospitalization expenses and total postoperative drainage),patients'satisfaction with postoperative cosmetic effect and incidence of complications were compared between the two groups.Results Compared with before operation,the levels of VEGF and Tg in the two groups decreased 24 hours after operation,the levels of TNF-αand CRP increased,the differences were statistically significant(P<0.05).The levels of VEGF,TNF-α,CRP and Tg in the observation group were significantly lower than those in the control group 24 hours after operation(P<0.05).There was no significant difference in the number of lymph nodes between the two groups(P>0.05).The operation time and hospital stay in the control group were longer than those in the observation group,the intraoperative blood output was more than that in the observation group,and the hospitalization expenses and total postoperative drainage were less than those in the observation group(P<0.05).The total satisfaction of the control group was 27.78%,significantly lower than that of the observation group(86.67%,P<0.05).The total complication rate in the control group was 22.22%,which was higher than that in the observation group(13.33%),but there was no significant difference between the two groups(P>0.05).Conclusion Complete areola approach for endoscopic thyroid surgery in patients with

关 键 词：甲状腺癌 腔镜术 开放性根治术 临床疗效 美观度 并发症 

分 类 号：R736.1[医药卫生—肿瘤]