经腋完全腔镜下不同入路手术对DTC患者的疗效及对其Tg等指标和预后的影响评估  

Evaluation of the effect of different approaches on DTC patients with complete axillary laparoscopy and its impact on Tg and other indicators and prognosis

作　　者：忽莎楠 王英凯 晁亚 HU Shanan;WANG Yingkai;CHAO Ya(Thyroid Surgery Department of Nanyang Central Hospital,Nanyang,Henan 473000;Ear,Nose and Throat Ward 2.Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院甲状腺外科,河南南阳473000 [2]南阳市中心医院耳鼻喉二病区,河南南阳473000

出　　处：《航空航天医学杂志》2025年第4期391-394,共4页Journal of Aerospace medicine

摘　　要：目的探讨经腋完全腔镜下不同入路手术对分化型甲状腺癌(DTC)患者的疗效及对其Tg等指标和预后的影响。方法选取自2020年01月-2022年05月我院85例甲状腺乳头状癌患者(均经腋完全腔镜甲状腺手术治疗),根据术式分为2组。其中研究组40例,采用胸锁乳突肌后缘入路,而对照组45例,则采用胸锁乳突肌间隙入路,比较2组临床疗效等差异。结果研究组的手术时间、术中出血量及疼痛评分均比对照组低,而淋巴结清扫数目则较高(P<0.05);两组的术后并发症发生率比较无差异(P>0.05);术前两组的炎性及预后指标比较无差异(P>0.05),术后两组术后炎性指标均较术前上升,预后指标均较术前降低,且研究组炎性指标、预后指标低于对照组(P<0.05);术后一年,研究组的复发率(0.0%)显著低于对照组(11.1%)(P<0.05)。结论胸锁乳突肌后缘入路手术对患者的疗效更佳,不仅可减轻其应激反应程度,同时在不增加手术风险情况下,可显著改善患者预后,值得临床推广应用。Objective To explore the efficacy of different approaches in DTC patients under complete axillary laparoscopy and its effects on Tg and prognosis of DTC patients and their Tg indicators and prognosis,Methods were selected from 85 patients with papillary thyroid cancer in our hospital from January 2020 to May 2022(all treated with complete axillary laparoscopic thyroid surgery),and were divided into 2 groups according to the procedure.Among them,40 cases in the study group adopted the posterior edge approach of the sternocleidomastoid muscle,while 45 cases in the control group adopted the sternocleidomastoid muscle space approach to compare the clinical efficacy and other differences in the two groups.The results showed that the surgical time,intraoperative blood loss,and pain score of the study group were lower than those of the control group,while the number of lymph node dissection scans was higher(P<0.05);There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05);There was no significant difference in the inflammatory and prognostic indicators between the two groups before surgery(P>0.05),The postoperative inflammatory indexes were increased and the prognostic indexes were decreased between the two groups after surgery.The inflammatory indexes and the prognostic indexes of the study group were lower than those of the control group(P<0.05);One year after surgery,the recurrence rate in the study group(0.0%)was significantly lower than that in the control group(11.1%)(P<0.05)Conclusion The posterior approach of sternocleidomastoid muscle surgery has better therapeutic effects on patients,not only reducing their stress response,but also significantly improving their prognosis without increasing surgical risks.It is worthy of clinical promotion and application.

关 键 词：经腋完全腔镜下 胸锁乳突肌后缘入路 胸锁乳突肌间隙入路 甲状腺癌 疗效 预后 

分 类 号：R737.9[医药卫生—肿瘤]