无充气与充气经腋窝入路腔镜切除术对分化型甲状腺癌喉返神经损伤及预后的影响  

Effect of Non-Insufflated and Insufflated Transaxillary Endoscopic Thyroidectomy on Recurrent Laryngeal Nerve Injury and Prognosis in Patients with Differentiated Thyroid Carcinoma

作　　者：陈亚琳 王晓彬 王晶 李妙玉 CHEN Yalin;WANG Xiaobin;WANG Jing(Qingdao Central Hospital,Rehabilitation University Qingdao Center Hospital,Qingdao Shandong 266042)

机构地区：[1]康复大学青岛中心医院(青岛市中心医院),山东青岛266042

出　　处：《医学临床研究》2024年第8期1135-1137,1140,共4页Journal of Clinical Research

摘　　要：【目的】探讨无充气与充气经腋窝入路腔镜切除术对分化型甲状腺癌患者喉返神经损伤及预后的影响。【方法】在本院接受经腋窝腔镜甲状腺癌根治术治疗的88例分化型甲状腺癌患者,依据手术方法不同分为无充气组(40例)和充气组(48例)。比较两组患者的甲状旁腺激素水平、复发率、手术时间、住院时间、失血量、引流量、喉返神经损伤发生率、生活质量评分(QOL)。【结果】手术后,无充气组甲状旁腺激素水平高于充气组(P<0.05);两组患者复发率比较,差异无统计学意义(P>0.05);无充气组手术时间和住院时间短于充气组,失血量和引流量少于充气组,暂时性喉返神经损伤发生率低于充气组(P<0.05)。术后3个月,无充气组QOL评分高于充气组(P<0.05)。【结论】无充气经腋窝入路腔镜切除术较充气手术能缩短手术时间与住院时间,降低失血量与引流量及暂时性喉返神经损伤发生率,同时患者具有更好的生活质量,值得临床推广应用。【Objective】To investigate the effect of non-insufflated and insufflated transaxillary endoscopic thyroidectomy on recurrent laryngeal nerve(RLN)injury and prognosis in patients with differentiated thyroid carcinoma(DTC).【Methods】Eighty-eight DTC patients undergoing transaxillary endoscopic thyroidectomy in our hospital were divided into a non-insufflated group(40 cases)and an insufflated group(48 cases)according to the different surgical methods.The levels of parathyroid hormone(PTH),recurrence rate,operation time,hospital stay,blood loss,drainage volume,incidence of RLN injury,and quality of life(QOL)scores were compared between the two groups.【Results】Postoperatively,the PTH level in the non-insufflated group was higher than that in the insufflated group(P<0.05).There was no statistically significant difference in the recurrence rates between the two groups(P>0.05).The operation time and hospital stay were shorter,and the blood loss and drainage volume were less in the non-insufflated group than in the insufflated group.The incidence of temporary RLN injury was lower in the non-insufflated group(P<0.05).At three months post-operation,the QOL scores in the non-insufflated group were higher than those in the insufflated group(P<0.05).【Conclusion】Compared to insufflated surgery,non-insufflated transaxillary endoscopic thyroidectomy can shorten the operation and hospital stay,reduce blood loss and drainage volume,and lower the incidence of temporary RLN injury.Additionally,patients have better quality of life postoperatively,making it worthy of clinical promotion and application.

关 键 词：甲状腺肿瘤/外科学 腹腔镜检查 喉返神经损伤 预后 

分 类 号：R736.1[医药卫生—肿瘤]