首页|颈前微切口腔镜手术对分化型甲状腺癌患者疗效、凝血功能及炎性指标的影响

颈前微切口腔镜手术对分化型甲状腺癌患者疗效、凝血功能及炎性指标的影响

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目的 探讨颈前微切口腔镜手术对分化型甲状腺癌(DTC)的疗效及对凝血、炎性指标的影响.方法 选择2020 年1 月—2022 年11 月收治的DTC 168 例,根据术式分为研究组 87 例和对照组 81 例.研究组采用颈前微切口腔镜甲状腺切除术,对照组采用传统甲状腺切除术.比较2 组围术期指标,手术前后凝血功能、炎性因子水平,术后并发症及切口美观度.结果 手术时间、住院时间方面,研究组较对照组短,淋巴结清扫数目则较对照组多,术后疼痛程度低于对照组(P<0.05).2 组术后活化部分凝血活酶时间(APTT)均短于术前,纤维蛋白原水平高于术前,但研究组APTT长于对照组,纤维蛋白原水平低于对照组(P<0.05).研究组术后咳嗽、声音嘶哑、吞咽困难发生率较对照组低(P<0.01).2 组术后白细胞计数及C反应蛋白均高于术前,但研究组低于对照组(P<0.05).研究组术后1 年温哥华瘢痕评定量表及患者与观察者瘢痕评估量表评分均低于对照组(P<0.05).结论 颈前微切口腔镜手术治疗DTC效果较好,可减轻炎症反应,改善凝血功能,切口美观.
Effect of Anterior Cervical Microincision Laparoscopic Surgery on Effica-cy,Coagulation Function,and Inflammatory Markers in Patients with DTC
Objective To investigate the effect of anterior cervical micro-incision laparoscopic surgery on differentia-ted thyroid carcinoma(DTC)and its impact on coagulation and inflammatory markers.Methods A total of 168 patients with DTC treated from January 2020 to November 2022 were selected and divided into the research group(n =87)and the control group(n =81)according to the surgical method.Anterior cervical micro-incision laparoscopic thyroidectomy was performed in the research group and traditional thyroidectomy was performed in the control group.Perioperative indexes,coagulation func-tion,inflammatory factor level,postoperative complications and incision aesthetics were compared between the two groups.Results The duration of surgery and length of hospital stay of the research group were shorter than those of the control group,the number of lymph node dissection was more than that of the control group,and the postoperative pain degree was lower than that of the control group(P<0.05).The activated partial thromboplastin time(APTT)was shorter and the fibrinogen level was higher in both groups,as compared with those before surgery,but the APTT of the research group was longer than that of the control group and the fibrinogen level was lower than that of the control group(P<0.05).The incidence of postoperative cough,hoarseness and dysphagia in the research group was lower than that in the control group(P<0.01).The white blood cell(WBC)count and C reactive protein in the two groups were higher than those before surgery,which were lower in the re-search group than in the control group(P<0.05).The scores of the Vancouver Scar Assessment Scale at 1 year after treat-ment and the Patient and Observer Scar Assessment Scale were lower in the research group than in the control group(P<0.05).Conclusion The effect of anterior cervical micro-incision laparoscopic surgery on DTC is good,which can reduce in-flammation,improve coagulation function and keep incision aesthetics.

Differentiated thyroid cancerAnterior cervical micro-incision laparoscopic surgeryThyroidectomyAc-tivated partial thromboplastin timeFibrinogenC reactive proteinPrognosis

年建泽、包召玉

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234000 安徽 宿州,安徽医科大学附属宿州医院 宿州市立医院普通外科六病区(甲乳外科)

分化型甲状腺癌 颈前微切口腔镜手术 甲状腺切除术 颈淋巴结清扫术 活化部分凝血活酶时间 纤维蛋白原 C反应蛋白 预后

2021年度安徽高校自然科学研究项目

KJ2021ZD0021

2024

10.3969/j.issn.2095-3097.2024.02.015

转化医学杂志
海军总医院

转化医学杂志

CSTPCD
影响因子：0.671
ISSN：2095-3097
年,卷(期)：2024.13(2)
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