经腋窝入路小切口腔镜和胸乳入路腔镜治疗甲状腺微小乳头状癌的效果比较  

Comparison of the Therapeutic Effects of Small Incision Laparoscopy through Axillary Approach and Thoracomammary Approach Laparoscopy in the Treatment of Papillary Thyroid Carcinoma

作　　者：胡小卫 刘清 丰枭 HU Xiaowei;LIU Qing;FENG Xiao(Zhejiang Provincial People's Hospital Bijie Hospital,Bijie 551700,China;不详)

机构地区：[1]浙江省人民医院毕节医院,贵州毕节551700

出　　处：《中外医学研究》2025年第4期9-13,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:观察在甲状腺微小乳头状癌的临床治疗中,经腋窝入路小切口腔镜和胸乳入路腔镜的治疗效果。方法:选取2021年10月—2023年10月浙江省人民医院毕节医院收治的80例甲状腺微小乳头状癌患者,按照随机信封法分为两组,各40例,对照组采用常规胸乳入路腔镜手术,研究组采用经腋窝入路小切口腔镜手术,对比两组临床疗效。结果:研究组外观满意度高于对照组,且术后3 d促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)、醛固酮(aldosterone,ALD)、皮质醇(cortisol,Cor)、降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)水平及视觉模拟评分(visual analogue score,VAS)评分低于对照组,手术时间和引流管拔除时间短于对照组,术中出血量和术后引流量少于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率为5.00%,和对照组的12.50%比较,差异无统计学意义(χ^(2)=1.409,P>0.05)。结论:和常规胸乳入路腔镜手术治疗甲状腺微小乳头状癌相比,经腋窝入路小切口腔镜手术能够进一步改善患者术后外观满意度,减轻术后创伤应激程度和炎症刺激,有助于在保证手术效果的基础上加快患者体征恢复,治疗安全性和实用性较高。Objective:To observe the therapeutic effects of small incision laparoscopy through axillary approach and thoracomammary approach laparoscopy in the treatment of papillary thyroid carcinoma.Method:Eighty patients with papillary thyroid carcinoma admitted to the Zhejiang Provincial People's Hospital Bijie Hospital from October 2021 to October 2023 were selected and divided into two groups by random envelope method,40 cases in each group.The control group received conventional thoracomammary approach laparoscopy,while the study group received small incision laparoscopy through axillary approach.The clinical efficacy of the two groups was compared.Result:The appearance satisfaction of the study group was higher than that of the control group,and the levels of adrenocorticotropic hormone(ACTH),aldosterone(ALD),cortisol(Cor),procalcitonin(PCT),C-reactive protein(CRP),and visual analogue scale(VAS)score at 3 d after surgery were lower than those of the control group,the surgery time and drainage tube removal time were shorter than those of the control group,and the intraoperative bleeding and postoperative drainage volume were less than those of the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group was 5.00%,compared with 12.50% in the control group,the difference was not statistically significant(χ^(2)=1.409,P>0.05).Conclusion:Compared with conventional thoracomammary approach laparoscopy in the treatment of papillary thyroid carcinoma,small incision laparoscopy through axillary approach can further improve patient satisfaction with postoperative appearance,reduce postoperative trauma stress and inflammatory stimulation,and help accelerate patient sign recovery while ensuring surgical effectiveness.The treatment is safe and practical.

关 键 词：经腋窝入路小切口腔镜 胸乳入路腔镜 甲状腺微小乳头状癌 外观满意度 创伤应激 炎症刺激 术后并发症 

分 类 号：R736.1[医药卫生—肿瘤]