经腋窝入路与经胸乳入路全腔镜单侧甲状腺叶切除术治疗单侧甲状腺良性肿瘤的效果比较  

Comparison of the Therapeutic Effects of Total Laparoscopic Unilateral Thyroidectomy Through Axillary Approach and Transthoracic Breast Approach for Unilateral Benign Thyroid Tumors

作　　者：李健 严顺新 李加洲 LI Jian;YAN Shunxin;LI Jiazhou(General Surgery Department,Shuyang Zhongxing Hospital,Shuyang 223600,China)

机构地区：[1]沭阳中兴医院普外科,江苏沭阳223600

出　　处：《中国医学创新》2025年第4期15-19,共5页Medical Innovation of China

摘　　要：目的:观察在单侧甲状腺良性肿瘤的临床治疗中,经腋窝入路与经胸乳入路全腔镜单侧甲状腺叶切除术的应用效果。方法:选取2019年1月—2023年11月沭阳中兴医院收治的单侧甲状腺良性肿瘤患者62例,按照信封法分为两组,各31例,两组均采用全腔镜单侧甲状腺叶切除手术,其中对照组经胸乳入路,研究组经腋窝入路,对比两组临床疗效。结果:研究组外观满意度高于对照组,且术后去甲肾上腺素(NE)、β-内啡肽(β-EP)、皮质醇(Cor)、白细胞计数(WBC)、C反应蛋白(CRP)水平及视觉模拟评分法(visual analogue scale,VAS)评分均低于对照组,手术时间短于对照组,术中出血量和术后引流量均少于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为6.46%,低于对照组的16.13%,两组比较差异无统计学意义(P>0.05)。结论:与经胸乳入路全腔镜单侧甲状腺叶切除术治疗单侧甲状腺良性肿瘤相比,经腋窝入路能够进一步改善患者术后外观满意度,减轻术后创伤应激刺激和炎症反应,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 application effect of total laparoscopic unilateral thyroidectomy through axillary approach and transthoracic breast approach in the clinical treatment of unilateral benign thyroid tumors.Method:A total of 62 patients with unilateral benign thyroid tumor admitted to Shuyang Zhongxing Hospital from January 2019 to November 2023 were selected and divided into two groups according to envelope method,with 31 patients in each group.Both groups underwent total laparoscopic unilateral thyroidectomy,with the control group through transthoracic breast approach and the study group 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 norepinephrine(NE),β-endorphin(β-EP),cortisol(Cor),white blood cell count(WBC),C reactive protein(CRP)and visual analogue scale(VAS)scores were lower than those of the control group,the operation time was shorter than that of the control group,and the intraoperative blood loss and postoperative drainage volume were lower than those of the control group,with statistical significance(P<0.05).The incidence of complications in the study group was 6.46%,which was lower than 16.13%in the control group,there was no significant difference between the two groups(P>0.05).Conclusion:Compared with the treatment of unilateral benign thyroid tumors through transthoracic breast approach,through axillary approach can further improve patient satisfaction with postoperative appearance,reduce postoperative trauma stress and inflammatory reactions,and help accelerate patient sign recovery while ensuring surgical effectiveness.The treatment is safe and practical.

关 键 词：经腋窝入路 经胸乳入路 全腔镜单侧甲状腺叶切除术 单侧甲状腺良性肿瘤 外观满 意度 创伤应激刺激 炎症反应 

分 类 号：R736.1[医药卫生—肿瘤]