摘要
目的 比较"低位领"式与"L"型切口淋巴结清扫术治疗甲状腺癌的临床效果.方法 选取 80 例甲状腺癌患者,按随机数字表法分为2 组,各40 例.对照组采取"L"型切口淋巴结清扫术,观察组施行"低位领"式淋巴结清扫术,观察至术后3 个月.对比2 组手术相关指标、切口满意度、颈肩部疼痛程度与心理状态、生活质量、并发症.结果 观察组术中出血量[(40.53±4.26)ml]少于对照组[(58.75±6.31)ml],手术时间[(118.79±10.53)min]与住院时间[(6.35±1.03)d]短于对照组[(146.35±12.69)min、(9.42±1.69)d],切口满意度[95.00%(38/40)]高于对照组[80.00%(32/40)],视觉模拟疼痛评估量表(VAS)评分[(3.56±0.48)分]与焦虑自评量表(SAS)评分[(39.46±4.33)分]、抑郁自评量表(SDS)评分[(40.63±5.20)分]低于对照组[(5.23±0.79)分、(47.53±6.36)分、(48.56±6.48)分],有统计学差异(P<0.05).术后3 个月,观察组生活质量综合评定问卷(GQOLI-74)内各维度评分[(80.38±3.75)分、(79.28±3.86)分、(80.63±4.01)分、(81.43±4.10)分]均高于对照组[(71.26±3.29)分、(70.56±3.49)分、(72.31±3.59)分、(71.31±3.50)分],有统计学差异(P<0.05).2 组并发症相比,差异无统计学意义(P>0.05).结论 与"L"型切口相比,"低位领"式淋巴结清扫术治疗甲状腺癌效果更佳,术中出血量更少,手术及术后住院时间更短,并能够减轻患者颈肩部疼痛,改善心理状态及生活质量,且无严重并发症.
Abstract
Objective To compare the clinical efficacy of"low collar"and"L"incision lymph node dissection in the treatment of thyroid cancer.Methods 80 patients with thyroid cancer were selected and randomly divided into 2 groups,each with 40 cases.The control group underwent"L"incision lymph node dissection,while the observation group underwent"low col-lar"lymph node dissection until 3 months after surgery.Compared the surgical related indicators,incision satisfaction,degree of neck and shoulder pain,psychological status,quality of life,and complications between the 2 groups.Results The intraoperative bleeding volume in the observation group[(40.53±4.26)ml]was lower than that in the control group[(58.75±6.31)ml],and the surgical time[(118.79±10.53)min]and hospital stay[(6.35±1.03)d]were shorter than those in the control group[(146.35±12.69)min,(9.42±1.69)d].The incision satisfaction[95.00%(38/40)]was higher than that in the control group[80.00%(32/40)],The score of the Visual Analog Pain Assessment Scale(VAS)[(3.56±0.48)points],the Self Rat-ing Anxiety Scale(SAS)score[(39.46±4.33)points],and the Self Rating Depression Scale(SDS)score[40.63±5.20)points]were lower than those of the control group[(5.23±0.79)points,(47.53±6.36)points,and(48.56±6.48)points],with statistical differences(P<0.05).After 3 months of surgery,the scores of various dimensions in the GQOLI-74 Comprehen-sive Quality of Life Assessment Questionnaire(GQOLI-74)in the observation group[(80.38±3.75)points,(79.28±3.86)points,(80.63±4.01)points,(81.43±4.10)points]were higher than those in the control group[(71.26±3.29)points,(70.56±3.49)points,(72.31±3.59)points,(71.31±3.50)points],with statistical differences(P<0.05).There was no sta-tistically significant difference in complications between the 2 groups(P>0.05).Conclusion Compared with the"L"incision,the"low collar"lymph node dissection surgery has a better effect on the treatment of thyroid cancer,with less intraoperative bleeding,shorter surgical and postoperative hospital stay,and can alleviate neck and shoulder pain,improve psychological status and quality of life,without serious complications.
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