经腋窝入路无充气腔镜下单侧甲状腺肿瘤切除术治疗甲状腺肿瘤患者的效果  

Effects of unilateral thyroidectomy through transaxillary approach without inflatable endoscope in treatment of patients with thyroid tumors

作　　者：候玉龙 HOU Yulong(st Department of Oncology of the Central Hospital of Jiamusi City,Jiamusi 154002 Heilongjiang,China)

机构地区：[1]佳木斯市中心医院肿瘤外一科,黑龙江佳木斯154002

出　　处：《中国民康医学》2023年第10期61-64,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察经腋窝入路无充气腔镜下单侧甲状腺肿瘤切除术治疗甲状腺肿瘤患者的效果。方法:回顾性分析2020年8月至2021年9月该院收治的91例行单侧甲状腺肿瘤切除术患者的临床资料。按照不同手术入路将其分为对照组(n=41)与观察组(n=50)。对照组实施经胸乳入路腔镜下切除术治疗,观察组实施经腋窝入路无充气腔镜下切除术治疗,比较两组围术期指标水平、炎性因子[视黄醇结合蛋白(RBP)、C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α]水平及甲状腺功能指标[三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))及促甲状腺激素(TSH)]水平、并发症发生率及切口满意度评分。结果:观察组手术时间长于对照组,术中出血量、术后引流量均少于对照组,差异有统计学意义(P<0.05);两组住院时间比较,差异无统计学意义(P>0.05);术后24 h,两组CRP、TNF-α水平均高于术前,但观察组低于对照组,两组RBP水平均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05);术后48 h,两组TSH水平均高于术前,FT_(3)、FT_(4)水平低于术前,但组间比较,差异均无统计学意义(P>0.05);观察组并发症发生率为4.00%,低于对照组的21.95%,差异有统计学意义(P<0.05);观察组切口隐匿、切口瘢痕、色素沉着、切口疼痛等各项切口满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论:经腋窝入路无充气腔镜下单侧甲状腺瘤切除术治疗甲状腺肿瘤患者可提高切口满意度,缩短手术时间,减少术中出血量和术后引流量,改善炎性因子水平,降低并发症发生率,效果优于经胸乳入路腔镜下切除术。Objective:To observe effects of unilateral thyroidectomy through transaxillary approach without inflatable endoscope in treatment of patients with thyroid tumors.Methods:The clinical data of 91 patients who underwent unilateral thyroidectomy in this hospital from August 2020 to September 2021 were retrospectively analyzed.According to different surgical approaches,they were divided into control group(n=41)and observation group(n=50).The control group was treated with endoscopic resection through breast approach,while the observation group was treated with thyroidectomy through transaxillary approach without inflatable endoscope.The perioperative index levels,the inflammatory factor levels[retinol binding protein(RBP),C-reactive protein(CRP),tumor necrosis factor(TNF)-α],the thyroid function index levels[triiodothyronine(FT_(3)),free thyroxine(FT_(4))and thyroid stimulating hormone(TSH)],the incidence of complications,and the incision satisfaction score were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group,the intraoperative blood loss and the postoperative drainage volume were less than those of the control group,and the differences were statistically significant(P<0.05).24 h after the surgery,the levels of CRP and TNF-αin the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group;the levels of RBP in the two groups were lower than those before the surgery,but that in the observation group was higher than that in the control group;and the differences were statistically significant(P<0.05).48 hours after surgery,the TSH levels in both groups were higher than before the surgery,and the levels of FT_(3) and FT_(4) in both groups were lower than before the surgery;However,there were no statistically significant differences between the groups(P>0.05).The observation group had lower incidence of complications as 4.00%than 21.95%in the control group,and the difference

关 键 词：腋窝入路 胸乳入路 腔镜 单侧甲状腺瘤切除术 促甲状腺激素 炎性因子 并发症 

分 类 号：R736.1[医药卫生—肿瘤]