腔镜下甲状腺全切与甲状腺次全切除术治疗双侧结节性甲状腺肿临床效果比较研究  

Comparative study on clinical efficacy of endoscopic total thyroidectomy and subtotal thyroidectomy in the treatment of bilateral nodular goiter

作　　者：刘桂林 吴桂蓉 黄春红 刘国生 LIU Guilin;WU Guirong;HUANG Chunhong;LIU Guosheng(Department of General Surgery,Dongguan Qingxi Hospital,Guangdong,Dongguan 523660,China)

机构地区：[1]广东省东莞市清溪医院普通外科,广东东莞523660

出　　处：《中国医药科学》2024年第12期130-133,183,共5页China Medicine And Pharmacy

基　　金：广东省东莞市社会发展科技项目(20211800901662)。

摘　　要：目的探讨腔镜甲状腺全切除术和次全切除术治疗双侧结节性甲状腺肿的效果。方法前瞻性研究选取广东省东莞市清溪医院普通外科2018年1月至2023年6月收治的60例双侧结节性甲状腺肿患者,按照治疗方式的不同分为对照组和观察组,每组各30例。观察组采用腔镜甲状腺全切除术治疗,对照组采用腔镜次全切除术治疗。比较两组手术指标、手术前后的甲状腺功能指标及炎症因子、并发症发生率及复发率。结果观察组各项手术指标均优于对照组(P<0.05)。手术后观察组甲状腺功能指标优于对照组(P<0.05)。手术后观察组血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)均低于对照组(P<0.05)。观察组术后并发症总发生率及复发率均低于对照组(P<0.05)。结论双侧结节性甲状腺肿患者应用腔镜甲状腺全切除术的效果确切,可加快患者恢复,改善甲状腺功能,减轻机体炎症反应,降低并发症发生率和复发率。Objective To investigate the effect of endoscopic total thyroidectomy and subtotal thyroidectomy in the treatment of bilateral nodular goiter.Methods A total of 60 patients with bilateral nodular goiter admitted to the Department of General Surgery of Dongguan Qingxi Hospital from January 2018 to June 2023 were prospectively selected,and were divided into the control group and the observation group according to different treatment methods,with 30 patients in each group.The observation group underwent endoscopic total thyroidectomy,while the control group underwent endoscopic subtotal thyroidectomy.The operation index,and thyroid function index,inflammatory factors,complication rate and recurrence rate before and after operation were compared between the two groups.Results The level of surgical indexes in the observation group was better than that in the control group(P<0.05).The thyroid function index of observation group was better than that of control group after operation,with statistically significant differences(P<0.05).After operation,the serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)in the observation group were lower than those in the control group(P<0.05).The total complication rate and recurrence rate after operation in the observation group were lower than those in the control group(P<0.05).Conclusion Endoscopic total thyroidectomy is effective in patients with bilateral nodular goiter,which can accelerate the recovery of patients,improve thyroid function,reduce the inflammatory rea ction of the body,and reduce the complication rate and recurrence rate.

关 键 词：双侧结节性甲状腺肿 甲状腺全切除术 次全切除术 炎症反应 复发率 

分 类 号：R653[医药卫生—外科学]