摘要
目的 探究腔镜根治术(ERT)治疗甲状腺癌(TC)患者的效果及对机体甲状腺功能、应激反应的影响.方法 回顾性收集我院84例TC患者(2020年2月-2023年2月)病例资料,按手术方案不同分成A组(n=42)、B组(n=42).A组行ERT,B组行开放根治术(OT),对比2组手术指标、手术前后甲状腺功能[三碘甲状腺原氨酸(T3)、促甲状腺激素(TSH)、甲状腺激素(T4)]水平、视觉模拟评分法(VAS)、应激反应[P物质(SP)、5-羟色胺(5-HT)、白介素-6(IL-6)、C反应蛋白(CRP)]水平、并发症发生率.结果 A组术中失血量相较于B组更低,A组切口总长度、手术用时、拔管时间、住院用时相较于B组更短(P＜0.05);A组术后3d血清T3、T4水平相较于B组更低,血清TSH水平相较于B组更高(P＜0.05);术后1d、3d、7d A组VAS评分相较于B组更低(P＜0.05);A组术后3d血清SP、5-HT、CRP、IL-6水平相较于B组更低(P＜0.05);A组并发症发生率2.38％(1/42)相较于B组19.05％(8/42)更低(P＜0.05).结论 相较于OT治疗TC患者,经ERT治疗更有助于减轻术后疼痛感,优化手术指标,改善甲状腺功能,减少并发症,且对机体应激反应影响更轻微.
Abstract
Objective To explore the effect of radical endoscopic surgery(ERT)on thyroid cancer(TC)patients and its influence on thyroid function and stress response.Methods The data of 84 patients with TC in our hospital(from Feb-ruary 2020 to February 2023)were retrospectively collected and divided into group A(n=42)and group B(n=42)ac-cording to different surgical protocols.Group A received ERT,group B received open radical operation(OT),The surgical indexes,thyroid function[triiodothyronine(T3),thyrotropin(TSH),thyroid hormone(T4)]levels,visual analogue score(VAS),stress re-sponse[Substance P(SP),5-hydroxytryptamine(5-HT),interleukin-6(IL-6),C-reactive protein(CRP)]levels before and after surgery were compared between the two groups,complication rate.Results The intraoperative blood loss in group A was lower than that in group B,and the total incision length,operation time,extubation time and hospitalization time in group A were shorter than those in group B(P＜0.05).The serum T3 and T4 levels in group A were lower than those in group B,and the serum TSH levels were high-er than those in group B(P＜0.05).The VAS score of group A was lower than that of group B on day 1,3 and 7 after sur-gery(P＜0.05).The levels of serum SP,5-HT,CRP and IL-6 in group A were lower than those in group B(P＜0.05).The complication rate of group A was 2.38％(1/42)lower than that of group B(19.05％(8/42)(P＜0.05).Conclu-sion Compared with OT treatment for TC patients,ERT treatment is more helpful to alleviate postoperative pain,optimize surgical indicators,improve thyroid function,reduce complications,and has less influence on the body stress response.
维普
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