甲状腺癌双孔免充气经腋窝入路腔镜术的疗效和术后并发症的影响因素  

Efficacy and factors influencing postoperativecomplications of double-hole non-inflatable transaxillaryendoscopic surgery in thyroid cancer

作　　者：刘翔[1] 朱巧俐 杜璐迪 LIU Xiang;ZHU Qiaoli;DU Ludi(Department of Breast and Thyroid Surgery,Quzhou Affiliated Hospital of Wenzhou Medical University,Quzhou People's Hospital,Quzhou 324000,China)

机构地区：[1]温州医科大学附属衢州医院/衢州市人民医院乳甲外科,浙江衢州324000

出　　处：《健康研究》2024年第3期328-332,共5页Health Research

基　　金：衢州市指导性科技攻关项目(2021027)。

摘　　要：目的观察双孔免充气经腋窝入路腔镜术与开放甲状腺癌根治术对患者炎症应激反应、美学效果的影响,并分析患者发生术后并发症的相关因素。方法98例甲状腺癌患者中,采用开放甲状腺癌根治术治疗者(对照组)和采用双孔免充气经腋窝入路腔镜术治疗者(观察组)各49例,统计并比较2组患者的手术状况、炎症因子水平、美学效果及术后并发症发生情况,采用Logistic回归分析影响患者发生术后并发症的相关因素。结果观察组术中出血量、手术时间及引流液量均高于对照组;2组治疗第3天的降钙素原(procalcitonin,PCT)、白细胞介素6(interleukin 6,IL-6)水平均高于治疗前,且观察组低于对照组;观察组美容满意度高于对照组;差异均有统计学意义(P<0.05)。98例甲状腺癌患者中有14例发生并发症,并发症发生率为14.29%;Logistic回归分析显示,年龄>45岁、肿瘤最长直径≥2 cm、术前PCT水平高均为患者发生术后并发症的影响因素(P<0.05)。结论相较于开放甲状腺癌根治术,双孔免充气经腋窝入路腔镜术可降低患者的炎症因子水平,且美容效果更好;45岁以上、肿瘤最长直径2 cm以上和术前PCT水平高的患者易发生术后并发症。Objective To observe the effects of non-inflatable dual-port transaxillary endoscopic surgery and open radical surgery for thyroid cancer on patients'inflammatory stress response and aesthetic outcomes,and to analyze the factors related to postoperative complications.Methods A total of 98 patients with thyroid cancer were included,with 49 patients treated with open radical thyroidectomy(control group)and 49 patients treated with non-inflatable dual-port transaxillary endoscopic surgery(observation group).The surgical status,levels of inflammatory markers,aesthetic outcomes,and incidence of postoperative complications were statistically analyzed and compared between the two groups.Logistic regression analysis was used to determine the factors influencing the occurrence of postoperative complications in patients.Results The observation group had higher intraoperative blood loss,longer operation time,and greater drainage fluid volume compared to the control group.The levels of procalcitonin(PCT)and interleukin 6(IL-6)on the third day of treatment were higher in both groups compared to pre-treatment levels,with the observation group showing lower levels than the control group.The aesthetic satisfaction was higher in the observation group than in the control group,with statistically significant differences(P<0.05).Among the 98 patients,14 cases experienced complications,resulting in a complication rate of 14.29%.Logistic regression analysis revealed that age over 45 years,tumor diameter≥2 cm,and high preoperative PCT levels were influencing factors for postoperative complications in patients(P<0.05).Conclusions Compared to open radical thyroidectomy,non-inflatable dual-port transaxillary endoscopic surgery can reduce inflammatory marker levels and provide better cosmetic results.Patients over 45 years old,with a tumor diameter exceeding 2 cm,and with high preoperative PCT levels are more likely to experience postoperative complications.

关 键 词：双孔免充气经腋窝入路腔镜术 甲状腺癌 炎症 美学 术后并发症 

分 类 号：R736.1[医药卫生—肿瘤]