摘要
目的探讨完全腔镜下手术在桥本甲状腺炎(HT)并发分化型甲状腺癌(DTC)患者中的应用效果。方法将2019年12月至2021年12月收治的100例HT并发DTC患者作为研究对象,采用简单随机法分为传统组50例(传统开放手术)和腔镜组50例(完全腔镜下手术)。整理并比较两组手术相关指标、并发症情况及术前、术后24 h和术后72 h的甲状腺功能指标、炎症因子的差异。结果腔镜组手术时间(124.58±34.81)min、术后住院时间(3.48±0.86)d短于传统组,术中出血量(25.03±5.11)ml和引流量(97.33±18.47)ml少于传统组,差异有统计学意义(P<0.05)。术后24 h,传统组的促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)低于术前,游离甲状腺素(FT4)与术前比较,无差异(P>0.05),腔镜组术后24 h时TSH、FT3、FT4与术前比较,差异无统计学意义(P>0.05);术后72 h,两组甲状腺功能指标与术前比较,差异无统计学意义(P>0.05)。腔镜组术后24 h的FT3高于传统组,其他时间点的甲状腺功能指标与传统组比较,差异无统计学意义(P>0.05)。术后24 h和术后72 h,两组超敏-C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)均高于术前,但腔镜组术后不同时间点的炎症指标均低于传统组,差异有统计学意义(P<0.05)。两组并发症比较,差异无统计学意义(P>0.05)。结论完全腔镜下手术治疗HT并发DTC可减轻炎症反应,对甲状腺功能影响较小,值得临床推荐。
Objective To investigate the application effect of complete endoscopic surgery in patients with Hashimoto thyroiditis(HT)complicated with differentiated thyroid carcinoma(DTC).Methods Taking 100 cases of HT complicated with DTC admitted from December 2019 to December 2021 as the research object,they were randomly divided into 50 cases in the traditional group(traditional open surgery)and 50 cases in the endoscopic group(complete endoscopic surgery).Sort out and compare the differences between the two groups in operation related indicators,complications,thyroid function indicators and inflammatory factors at 24 h and 72 h after operation.Results The operation time(124.58±34.81)min and postoperative hospital stay(3.48±0.86)d in the endoscopic group were shorter than those in the traditional group,and the intraoperative bleeding volume(25.03±5.11)ml and drainage volume(97.33±18.47)ml were less than those in the traditional group,the difference was statistically significant(P<0.05).At 24 hours after operation,TSH and free triiodothyronine(FT3)in the traditional group were lower than those before operation,and free thyroxine(FT4)had no difference compared with those before operation(P>0.05).At 24 hours after operation,TSH,FT3and FT4in the endoscopic group had no difference compared with those before operation(P>0.05).There was no difference in thyroid function between the two groups 72 hours after operation(P>0.05).FT3in endoscopic group was higher than that in traditional group 24 hours after operation,and there was no difference in thyroid function indexes at other time points compared with traditional group(P>0.05).At 24 h and 72 h after operation,hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-10(IL-10)were higher than those before operation,but the inflammatory indexes at different time points after operation in the endoscopic group were lower than those in the traditional group,and the difference was statistically significant(P<0.05).There was no
作者
高峰
吕金
王子斌
卢伟燕
姜玉石
GAO Feng;LV Jin;WANG Zi-bin;LU Wei-yan;JIANG Yu-shi(Hebei Petro China Central Hospital,Langfang,Hebei 065000,China)
出处
《中国地方病防治》
CAS
2022年第6期455-458,共4页
Chinese Journal of Control of Endemic Diseases
基金
廊坊市科学技术研究与发展计划项目(2021013153)。
关键词
腔镜手术
传统开放手术
桥本甲状腺炎
分化型甲状腺癌
炎症因子
Endoscopic surgery
Traditional open surgery
Hashimoto thyroiditis
Differentiated thyroid carcinoma
Inflammatory factor
