经胸入路腔镜甲状腺手术治疗甲状腺结节的疗效及术后引流液的性质与成分分析  

The Efficacy of Transthoracic Laparoscopic Thyroid Surgery for the Treatment of Thyroid Nodules and the Analysis of the Properties and Components of Postoperative Drainage Fluid

作　　者：杨昌毅 YANG Changyi(Department of General Surgery,Nan'an Hospital,Quanzhou,Fujian Province,362300 China)

机构地区：[1]福建省南安市医院普外科,福建泉州362300

出　　处：《中外医疗》2021年第34期79-82,90,共5页China & Foreign Medical Treatment

摘　　要：目的探讨经胸入路腔镜甲状腺手术治疗甲状腺结节的疗效及术后引流液性质与成分分析。方法方便选取该院2019年6月—2021年3月收治的92例甲状腺结节患者,使用计算机统计学软件SAS将患者随机分成两组,各46例。分组后对照组以传统甲状腺切除术治疗,观察组以经胸入路腔镜甲状腺手术治疗。对比两组患者的围术期关键性指标水平、并发症情况、术后疼痛、引流量性质、血清炎性因子水平。结果观察组切口长度(20.03±6.20)mm短于对照组,术中出血量(35.20±11.30)mL少于对照组,住院时间(6.50±1.82)d短于对照组,差异有统计学意义(t=17.289、10.852、4.060,P<0.05)。观察组术后吞咽不适等并发症发生率为10.87%,对照组发生率为32.61%,两组对比差异有统计学意义(χ^(2)=6.389,P<0.05)。术后观察组VAS(4.28±1.58)分低于对照组,且镇痛药物使用率21.74%低于对照组,差异有统计学意义(t=3.387,χ^(2)=6.900,P<0.05)。观察组引流液透明度中透明、微混高于对照组,差异有统计学意义(χ^(2)=11.220、4.564,P<0.05);观察组引流液pH值、PTH低于对照组,差异有统计学意义(t=4.092、7.222,P<0.05)。两组患者术前血清炎性因子指标白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)对比差异无统计学意义(P>0.05);术后观察组IL-6、TNF-α指标分别(30.55±5.61)pg/mL、(24.35±3.65)pg/mL均低于对照组,差异有统计学意义(t=8.898、13.959,P<0.05)。结论更换甲状腺结节手术的入路方式,采用经胸入路可有效改善患者的手术体验,缩短恢复时间和住院时间,降低疼痛程度,术后炎性指标更低,引流液更为清澈,是一种具有较高应用价值的手术方式。Objective To investigate the effect of transthoracic laparoscopic thyroid surgery for the treatment of thyroid nodules and the analysis of the components of postoperative drainage fluid.Methods A total of 92 patients with thyroid nodules admitted to the hospital from June 2019 to March 2021 were conveniently selected.The patients were randomly divided into two groups with 46 cases in each group used the computer statistical software SAS.After grouping,the control group was treated with traditional thyroidectomy,and the observation group was treated with transthoracic laparoscopic thyroid surgery.The perioperative key index levels,complications,postoperative pain,the nature of drainage,and serum inflammatory factor levels were compared between the two groups of patients.Results The length of incision in the observation group was(20.03±6.20)mm shorter than that of the control group,the intraoperative blood loss(35.20±11.30)mL was less than that of the control group,and the hospital stay was(6.50±1.82)d shorter than the control group,the difference was statistically significant(t=17.289,10.852,4.060,P<0.05).The incidence of postoperative swallowing discomfort and other complications in the observation group was 10.87%,and the incidence in the control group was 32.61%.There was a significant difference between the two groups,the difference was statistically significant(χ^(2)=6.389,P<0.05).The VAS(4.28±1.58)points of the postoperative observation group was lower than that of the control group,and the analgesic use rate was 21.74%lower than that of the control group,the difference was statistically significant(t=3.387,χ^(2)=6.900,P<0.05).The transparency of the drainage fluid of the observation group was transparent and slightly mixed higher than that of the control group,the difference was statistically significant(χ^(2)=11.220,4.564,P<0.05);the pH value and PTH of the drainage fluid of the observation group were lower than those of the control group,the difference was statistically significant(t=4.092,7.222,P<

关 键 词：甲状腺结节 入路方式 经胸入路 引流液 手术创新 

分 类 号：R5[医药卫生—内科学]