胸乳入路腔镜手术治疗甲状腺良性肿瘤的临床疗效及对应激激素的影响  

Observation on clinical effect and stress hormone index of thoracic and breast approach endoscopic surgery for benign thyroid tumor

作　　者：于海 陈万志[2] 曾伟立 方金华 YU Hai;CHEN Wan-zhi;ZENG Wei-li;FANG Jin-hua(People's Hospital of Dongxiang District,Fuzhou City,Jiangxi Province,331800,China;The Second Affiliated Hospital of Nanchang University,Nanchang City,Jiangxi Province,330008,China)

机构地区：[1]江西省抚州市东乡区人民医院,江西抚州331800 [2]南昌大学第二附属医院,江西南昌330008

出　　处：《蛇志》2022年第2期174-176,198,共4页Journal of Snake

基　　金：抚州市社会发展指导性科技计划项目(项目名称:经胸乳入路腹腔镜下甲状腺良性肿瘤切除术与传统手术的临床对比研究;抚科计字[2020]20号-89)。

摘　　要：目的探讨胸乳入路腔镜手术治疗甲状腺良性肿瘤的临床效果。方法选择2019年1月~2022年1月我院收治的甲状腺良性肿瘤患者70例,采用随机数字表法分为两组,各35例。对照组实施传统手术治疗,观察组行胸乳入路腔镜手术治疗。比较两组患者的临床指标、应激激素指标[去甲肾上腺素(NE)、血清超氧化物歧化酶(SOD)、皮质醇(Cor)]以及并发症发生情况。结果与对照组比较,观察组的手术时间长、术后引流量少、颈部恢复活动时间及住院时间短,且并发症发生率低,差异均有统计学意义(均P<0.05)。两组患者术前的应激指标比较,差异无统计学意义(P>0.05);两组患者术后的NE、Cor水平均有降低,SOD水平均升高,且观察组各指标改善效果明显优于对照组,差异均有统计学意义(均P<0.05)。结论胸乳入路腔镜手术治疗甲状腺良性肿瘤的效果好,手术创伤小,并发症少,有利于减轻机体应激反应,促进患者术后恢复,值得临床应用。Objective To investigate the clinical effect of endoscopic thoracic and breast approach in the treatment of benign thyroid tumors.Methods 70 patients with benign thyroid tumor admitted to our hospital from January 2019 to January 2022 were selected and divided into two groups by random number table method,35 cases in each group.Conventional surgery was performed in the control group,and endoscopic surgery was performed in the observation group.Clinical indexes,stress hormone indexes[norepinephrine(NE),serum superoxide dismutase(SOD),cortisol(Cor)]and complications were compared between the two groups.Results Compared with the control group,the observation group had longer operation time,less postoperative drainage,shorter neck recovery time and hospitalization time,and lower incidence of complications,with statistical significance(P<0.05for each).There was no significant difference in preoperative stress indexes between the two groups(P>0.05).NE and Cor levels in both groups decreased and SOD levels increased after operation,and the changes in the observation group were more obvious,with statistical significance(P<0.05 for each).Conclusion Endoscopic surgery with breast and chest approach for benign thyroid tumor has better therapeutic effect and less surgical trauma,which is beneficial to postoperative recovery,reduces complications and alleviates stress response of the body.It is worthy of extensive clinical application.

关 键 词：甲状腺良性肿瘤 胸乳入路腔镜手术 应激激素 

分 类 号：R653[医药卫生—外科学] R736.1[医药卫生—临床医学]