改良Miccoli手术在甲状腺癌治疗中的应用  

The application of modified Miccoli operation in the treatment of thyroid cancer

作　　者：魏勇军 张文娟 詹斌 高凯 王志祥 白彩恋 刘亚辉 WEI Yong-jun;ZHANG Wen-juan;ZHAN Bin(Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xiamen Medical College,Xiamen 361021,C hina)

机构地区：[1]厦门医学院附属第二医院耳鼻咽喉头颈外科,福建厦门361021

出　　处：《腹腔镜外科杂志》2022年第11期806-809,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨改良Miccoli手术在甲状腺癌治疗中的应用效果。方法:选择2017年9月至2019年3月收治的96例甲状腺癌患者,随机分为两组,对照组(n=48)行常规手术,观察组(n=48)行改良Miccoli手术。记录两组切口长度、手术时间、术中失血量、淋巴结清扫数量、术后住院时间等指标,术后3 d检测两组血清白介素-6、肿瘤坏死因子-α、超敏C反应蛋白等炎症因子水平,采用数字评价量表对两组患者术后3 d疼痛程度进行评定,采用瘢痕评估量表对术后3个月颈部美观度进行评定,统计两组术后并发症发生率及术后两年复发率。结果:观察组切口长度短于对照组(P<0.05),手术时间、术中失血量、术后住院时间少于对照组(P<0.05);两组淋巴结清扫数量差异无统计学意义(P>0.05);术后3 d,观察组血清白介素-6、肿瘤坏死因子-α、超敏C反应蛋白水平及疼痛评分均低于对照组(P<0.05);观察组并发症发生率及术后3个月瘢痕评分亦低于对照组(P<0.05);两组术后2年复发率差异无统计学意义(P>0.05)。结论:改良Miccoli手术治疗甲状腺癌效果显著,具有切口小、手术时间短、术后炎症轻、并发症发生率低、术后康复快、对颈部外观影响小等优势。Objective:To investigate the application effects of modified Miccoli operation in the treatment of thyroid cancer.Methods:A total of 96 patients with thyroid cancer who were treated from Sep.2017 to Mar.2019 were selected and randomly divided into two groups.Among them,48 patients who underwent conventional surgery were set as the control group,and 48 patients who u nderwent modified Miccoli surgery were set as the treatment group.The incision length,operation time,intraoperative blood loss,number of lymph node dissection,postoperative hospital stay and other related indicators in the two groups were recorded,the levels of serum interleukin-6,tumor necrosis factor-α,high-sensitivity C-reactive protein and other inflammatory factors were detected 3 d after surgery,pain degree on the third day after surgery was evaluated by numerical rating scale in the two groups.Patient scar assessment scale was used to evaluate the aesthetic appearance of the neck in 3 months after the surgery.The incidence of postoperative complications and the recurrence rate in 2 years after surgery were counted in the two groups.Results:The length of incision in the treatment group was signif icantly shorter than that in the control group(P<0.05),the operation time,intraoperative blood loss,and postoperative hospital stay were significantly less than those in the control group(P<0.05),the number of lymph node dissected was not obviously different from that in the control group(P>0.05);the levels of serum interleukin-6,tumor necrosis factor-α,high-sensitivity C-reactive protein and pain score in the treatment group were significantly lower than those in the control group on 3 d after surgery(P<0.05);the incidence of complications and the scar score in 3 months after operation in the treatment group were lower compared with the control group(P<0.05);there was no significant difference in the 2-year recurrence rate between the two groups(P>0.05).Conclusions:Modified M iccoli surgery is effective in the treatment of thyroid cancer,with the adv

关 键 词：甲状腺肿瘤 Miccoli手术 改良 

分 类 号：R736.1[医药卫生—肿瘤]