摘要
目的探讨3种甲状腺手术对患者的治疗效果及对患者免疫功能和生活质量的影响。方法选取2014年6月至2017年6月在河北中石油中心医院接受甲状腺手术治疗的患者90例,根据随机数字表法将其分为腹腔镜辅助的小切口甲状腺切除术(minimally invasive video assisted thyroidectomy,MIVAT)组、完全腔镜甲状腺切除术(total endoscopic thyroidectomy,TET)组以及甲状腺次全切除术(subtotal thyroidectomy,ST)组,每组30例。观察3组患者手术一般情况,比较3组患者术前和术后第1、3、5天白细胞介素 6(IL 6)、肿瘤坏死因子(TNF) α、C反应蛋白(CRP)、免疫球蛋白IgM、IgG、白细胞计数、中性粒细胞百分比的差异,观察3组患者手术前后生活质量的差别。结果3组患者的手术时间无明显差别,MIVAT组和TET组的术中出血量较ST组少,术后住院时间较ST组短,而2组间比较无明显差别;3组患者术前和术后1 d的细胞因子水平无差别,术后3 d和术后5 d时,MIVAT组和TET组的IL 6、TNF α和hs CRP水平均低于ST组,而2组间比较无差别;3组患者术前和术后1 d的免疫球蛋白和血常规指标无差别,术后3d和术后5 d MIVAT组和TET组的IgM、IgG水平高于ST组,白细胞计数和中性粒细胞百分比低于ST组;3组患者术前和术后1d的焦虑和卡氏生活质量评分系统(KPS)评分无差别,术后3 d和术后5 d,MIVAT组和TET组的焦虑得分低于ST组,KPS评分高于ST组。结论MIVAT和TET对甲状腺瘤患者有较好的手术效果,且对患者免疫功能影响小,可明显提高患者术后生活质量。
Objective To investigate the therapeutic effects of 3 kinds of thyroid surgery on the immune function and life quality of the patients involved.Methods The 90 patients who underwent thyroid surgery in the Hebei Petro China Central Hospital from June 2014 to June 2017 were enrolled as study subjects,and they were randomly divided into the minimally invasive video assisted thyraidectomy group(or the MIVAT group),the total endoscopic thyroidectomy group(or the TET group)and the subtotal thyroidectomy group(or the ST group),each consisting of 30 patients.General conditions of surgery,levels of interleukin 6(IL 6),TNF α,C reactive protein(CRP),immunoglobulin IgM,IgG,and total counts of WBC,neutrophil percentage before surgery and 1,3 and 5 days after surgery were compared between the patients of the 3 groups.Besides,differences in the life quality before and after surgery were compared between the patients of the 3 groups.Results There were no significant differences in surgical time in the patients of the 3 groups.As compared with that of the the ST group,the hemorrhage amounts of the MIVAT and the TET groups were lower,and the hospitalization stay was shorter.However,there were no significant differences,when comparisons were made between the MIVAT and the TET groups.There were no differences in cytokine levels both before surgery and one day after surgery,when comparisons were made between the patients of the 3 groups.The levels of IL 6,TNF α and hs CRP at day 3 and day 5 in the MIVST and TET groups were lower than those of the ST group.However,no statistical differences could be noted,when comparisons were made between the MIVAT and the TET groups.There were no differences in the levels of immunoglobulin and blood routine before surgery and one day after surgery for the patients of the 3 groups.The IgM and IgG levels of the MIVAT and TET groups 3 and 5 days after surgery were higher than those of the ST group,but total white blood cell count and neutrophil ratio were lower than those of the ST group.There were n
作者
李阳
卢伟燕
陈伟
张雷
杨晓峰
姜玉石
Li Yang;Lu Weiyan;Chen Wei;Zhang Lei;Yang Xiaofeng;Jiang Yushi(Hebei Petro China Central Hospital,Langfang 065000,China)
出处
《海军医学杂志》
2020年第1期56-59,62,共5页
Journal of Navy Medicine
基金
廊坊市科技支撑计划项目(2017013055)
关键词
甲状腺
免疫
生活质量
腹腔镜
Thyroid gland
Immunity
Life quality
Abdominoscope
