经胸乳入路腔镜手术治疗甲状腺癌的临床观察  

Clinical observation of transthoracic approach endoscopic surgery for thyroid cancer

作　　者：孙建 赵明慧 赵恩春[1] 刘威辰 Sun Jian;Zhao Minghui;Zhao Enchun;Liu Weichen(Department of General Surgery,Huai'an Traditional Chinese Medicine Hospital,Huai'an Jiangsu Province 223001,China)

机构地区：[1]淮安市中医院普外科,江苏淮安223001

出　　处：《中华普外科手术学杂志(电子版)》2025年第2期204-207,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨经胸乳入路腔镜与传统手术治疗甲状腺乳头状癌的临床疗效及术后并发症。方法选取自2022年7月至2023年12月收治且诊断为甲状腺乳头状癌的60例患者,采用随机数字表法将患者随机分为对照组和观察组,每组患者各30例。对照组患者采用传统开放手术方案,观察组患者采用经胸乳入路腔镜术。采用SPSS 20.0软件处理数据,计量资料以(±s)表示,组间比较采用独立样本t检验,不同时间点比较采用重复测量方差分析;计数资料用[例(%)]表示,行χ^(2)检验;TNM分期、病理分型等级资料行秩和检验。P<0.05为差异具有统计学意义。结果观察组患者手术时间显著长于对照组、术后出血量显著少于对照组、手术切口长度显著短于对照组(P<0.05);观察组患者术后疼痛视觉模拟评分法(VAS)评分、Vancouver疤痕评定量表(VSS)评分、C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)及促甲状腺激素(TSH)、并发症发生率均显著低于对照组(P<0.05)。结论相较于传统手术方案,甲状腺乳头状癌经胸乳入路腔镜手术能够提高临床疗效,改善患者术后炎症因子及甲状腺激素水平。Objective To investigate the clinical effect and postoperative complications of transthoracic approach endoscopy and traditional surgery in the treatment of papillary thyroid carcinoma.Methods A total of 60 patients diagnosed with papillary thyroid carcinoma admitted from July 2022 to December 2023 were selected and divided into control group and observation group by random number table method,with 30 patients in each group.The control group underwent traditional open surgery,and the observation group underwent transthoracic approach endoscopy.SPSS 20.0 software was used to process the data,and the measurement data were expressed as(±s).Independent sample t test was used for comparison between groups,and repeated measurement ANOVA was used for comparison at different time points.The count data were represented by[cases(%)]andχ^(2)test was performed.TNM stage,pathological classification grade data row rank sum test.P<0.05 was considered statistically significant.Results The operation time of observation group was significantly longer than that of control group,the postoperative blood loss was significantly less than that of control group,and the length of surgical incision was significantly shorter than that of control group(P<0.05).Observation group postoperative pain visual analogue Scale(VAS)score,Vancouver Scar Rating Scale(VSS)score,C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),serum free triiodothyronine(FT3),serum free thyroxine(FT4)and serum free thyroxine(FT4)score The incidence of thyroid stimulating hormone(TSH)and complications were significantly lower than those in control group(P<0.05).Conclusion Compared with traditional surgery,transthoracic approach endoscopic surgery for papillary thyroid carcinoma can improve the clinical efficacy and the levels of inflammatory factors and thyroid hormones.

关 键 词：甲状腺肿瘤 癌 乳头状 甲状腺切除术 胸乳入路腔镜 

分 类 号：R73[医药卫生—肿瘤]