锁骨下入路腔镜手术和传统开放手术治疗甲状腺癌的比较  

Comparison of subclavian approach endoscopic surgery and traditional open surgery in the treatment of thyroid cancer

作　　者：乔楠 王明军[1] QIAO Nan;WANG Mingjun(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan)

机构地区：[1]河南科技大学第一附属医院,河南洛阳471000

出　　处：《菏泽医学专科学校学报》2023年第3期33-36,共4页Journal of Heze Medical College

摘　　要：目的探究锁骨下入路腔镜手术与传统开放手术在甲状腺癌(TC)患者治疗中的应用价值。方法选取我院收治的TC患者124例,随机数字表法分为观察组和对照组,每组62例。观察组实施锁骨下入路腔镜手术,对照组实施传统开放手术。比较两组手术相关指标、术后各时间疼痛程度(VAS评分)、手术前后细胞免疫功能(CD3^(+)、CD4^(+)、CD8^(+))、肿瘤标志物[甲状腺球蛋白(Tg)、癌胚抗原(CEA)]及并发症。结果观察组手术时间长于对照组,住院时间短于对照组,术中出血量、术后引流量少于对照组,两组比较,P均<0.05。术后1d、3d、7d观察组VAS评分均低于对照组(P<0.05)。术后1d、3d观察组CD3^(+)、CD4^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。术后3d观察组Tg、CEA低于对照组(P<0.05)。两组并发症发生率比较,P>0.05。结论锁骨下入路腔镜手术和传统开放手术治疗TC安全性均较高,锁骨下入路腔镜手术创伤轻微,能减轻免疫抑制,有效缓解术后疼痛;而传统开放手术操作简单,手术时间较短。Objective To explore the value of subclavian approach endoscopic surgery and traditional open surgery in the treatment of patients with thyroid cancer(TC).Methods 124 patients with TC were selected and randomly divided into the observation group and the control group,62 cases in each group.The observation group received subclavian approach endoscopic surgery and the control group received traditional open surgery.The surgery-related indexes,pain level(VAS score)at each postoperative time,cellular immune function[lymphocytes(CD3^(+)),CD4^(+),CD8^(+)],tumor markers[thyroglobulin(Tg),carcinoembryonic antigen(CEA)]and complications before and after surgery were compared between the two groups.Results The observation group had longer operation time than the control group,shorter hospitalization time than the control group,less intraoperative bleeding and postoperative drainage than the control group(P<0.05).The VAS score of the++observation group was lower than that of the control group at 1 d,3 d,and 7 d after operation(P<0.05);the CD3 and CD4 of+the observation group were higher than that of the control group at 1 d and 3 d after operation,and the CD8 was lower than that of the control group(P<0.05);Tg and CEA in the observation group were lower than those in the control group at 3 d after operation(P<0.05);there was no significant difference in the complication rate between the two groups(P>0.05).Conclusion Subclavian approach endoscopic surgery and traditional open surgery are safer in the treatment of TC.Subclavian approach endoscopic surgery has mild invasion,reduce immunosuppression,and effectively relieve postoperative pain,while traditional open surgery is simple and has shorter operative time.

关 键 词：甲状腺癌 锁骨下入路 开放手术 疗效 

分 类 号：R736.1[医药卫生—肿瘤]