摘要
目的:探讨全乳晕入路术治疗肿大原发性甲状腺功能亢进(简称甲亢)临床疗效及手术安全性。方法:收集2014年8月至2017年8月广东省湛江中心人民医院收治的肿大原发性甲亢患者80例,按手术方式不同分为全乳晕入路组(n=43)和胸乳入路组(n=37)。比较两组术中出血量、切口长度、手术时间、术后引流时间、住院时间、术后下床活动时间以及应激反应情况。采用数字评分系统(NSS)评价两组对切口瘢痕美观的满意度,并记录并发症发生率。结果:与胸乳入路组比较,全乳晕入路组术中出血量明显减少,切口长度减小,术后下床活动时间缩短(P<0.05)。两组术毕时血清白介素-6(IL-6)、C反应蛋白(CRP)、皮质酮(CORT)水平均较术前明显增高,且全乳晕入路组血清CRP、CORT水平低于胸乳入路组(均P<0.05)。全乳晕入路组术后1个、3个、6个月的NSS评分均高于胸乳入路组(均P<0.05)。两组并发症发生率比较无明显差异(P>0.05)。结论:全乳晕入路术的切口更小,术中出血量少,术后下床活动早,且能减轻患者术毕时的应激反应,美观度更好,值得临床推广。
Objective: To investigate the effects and safety of total areola approach in the treatment of primary hyperthyroidism. Methods: The clinical data of 80 patients with primary hyperthyroidism admitted to our hospital from August 2014 to August 2017 were analyzed retrospectively.They were divided into the total areola approach group ( n =43) and the thoraco breast approach group ( n =37) according to the operative mode.The bleeding volume,incision length,operative time,postoperative drainage time,hospital stay,ambulation time and the incidence of complications were compared between the two groups.Serum levels of interleukin-6 (IL-6),C reactive protein (CRP) and corticosterone (CORT) were measured.NSS was used to evaluate the satisfaction to the beauty of incision scar. Results: The operative blood loss,incision length and postoperative ambulation time of the whole areola approach group were lower than those of the thoraco breast approach group ( P <0.05).The serum levels of IL-6,CRP and CORT in both groups were increased after operation,and serum CRP and CORT levels in the total areola approach group were lower than those in the thoraco breast approach group ( P <0.05).The NSS score of the total areola approach group was higher than that of the breast and breast approach group at 1,3 and 6 months after operation ( P <0.05).There was no significant difference in the incidence of complications between the two groups ( P >0.05). Conclusion: Compared with thoraco breast approach,total areola approach has shorter incision length,less intraoperative blood loss and earlier postoperative ambulation.It can reduce the stress response of patients at the end of operation and has better aesthetic appearance and higher clinical popularization value.
作者
洪新凯
王和鑫
邓小细
Hong Xinkai;Wang Hexin;Deng Xiaoxi(The People’s Hospital of Guangdong Zhanjiang Center,Zhanjiang 524000,China)
出处
《广西医科大学学报》
CAS
2019年第7期1160-1163,共4页
Journal of Guangxi Medical University
基金
湛江市非资助科技攻关计划课题资助项目(No.2017B01197)
关键词
全乳晕入路
胸乳入路
肿大原发性甲亢
美观度
total areola approach
thoraco breast approach
primary hyperthyroidism
aesthetic
