免充气经锁骨下入路腔镜手术对cN0期单侧甲状腺乳头状癌患者颈部功能、应激反应的影响  

Effect of non-inflatable subclavian endoscopic surgery on cervical function and stress response in patients with stage cN0 unilateral papillary thyroid cancer

作　　者：张洁 许文静 王莎莎 Zhang Jie;Xu Wen-jing;Wang Sha-sha(Operation Room,The First Affiliated Hospital of Henan University,Kaifeng 473000,Henan,China)

机构地区：[1]河南大学第一附属医院手术室,河南开封473000

出　　处：《四川生理科学杂志》2024年第11期2376-2378,共3页

基　　金：2021年河南省医学科技攻关计划联合项目(LHGJ20210554)。

摘　　要：目的:探究免充气经锁骨下入路腔镜手术对cN0期单侧甲状腺乳头状癌(Papillary thyroid carcinoma,PTC)患者颈部功能、应激反应的影响。方法:选取2021年10月至2023年10月期间本院收治的cN0期单侧PTC患者114例作为研究对象。随机将患者分为三组,每组各38例。分别采用常规开放手术、免充气经腋窝入路腔镜手术、免充气经锁骨下入路腔镜手术。分析对比三组的颈部功能、应激反应以及并发症。结果:三组术后3 d、3m的颈部疼痛评分、颈部损伤指数比较均无显著差异;腔镜组术后3 d、3 m的吞咽障碍指数均明显低于开放手术组(P<0.05)。术后,腋窝腔镜组的皮质醇、去甲肾上腺素水平均明显低于开放手术组,超氧化物歧化酶水平明显高于开放手术组(P<0.05),而锁骨下腔镜组的应激反应指标改善均明显优于腋窝腔镜组(P<0.05)。三组的并发症发生率无显著差异。结论:免充气经锁骨下入路腔镜手术可以减轻对cN0期单侧PTC患者吞咽功能、应激反应的影响,且不增加并发症,安全性较高。Objective:To investigate the effects of inflation-free subclavian endoscopic surgery on cervical function and stress response in patients with stage cN0 unilateral papillary thyroid carcinoma(PTC).Methods:114 patients with unilateral PTC at cN0 stage admitted to our hospital from October 2021 to October 2023 were selected as the study objects.Patients were divided into three groups randomly,with 38 cases in each group.Conventional open surgery,non inflatable axillary endoscopic surgery,and non inflatable subclavian endoscopic surgery were performed separately.The neck function,stress response,and complications of the three groups were analyzed and compared.Result:There was no significant difference in neck pain scores and neck injury index among the three groups at 3 days and 3 months after surgery;The swallowing disorder index of the endoscopic group was significantly lower than that of the open surgery group at 3 days and 3 months after surgery(P<0.05).After surgery,the levels of cortisol and norepinephrine in the axillary endoscopy group were significantly lower than those in the open surgery group,and the level of superoxide dismutase was significantly higher than that in the open surgery group(P<0.05).The improvement of stress response indicators in the subclavian endoscopy group was significantly better than that in the axillary endoscopy group(P<0.05).There was no significant difference in the incidence of complications among the three groups.Conclusion:Inflation-free subclavicular endoscopic surgery can reduce the impact on the swallowing function and stress response of unilateral PTC patients with stage cN0,without increasing complications,and has high safety.

关 键 词：免充气经锁骨下入路腔镜手术 cN0期 单侧甲状腺乳头状癌 颈部功能 应激反应 并发症 

分 类 号：R736.1[医药卫生—肿瘤]