腔镜在高龄甲状腺癌患者中的应用效果研究

On the effect of endoscopy in elderly patients with thyroid cancer

目的:探讨分析腔镜在高龄甲状腺癌患者中的应用效果。方法:选取2018年9月至2019年9月收治的120例甲状腺癌高龄患者,随机分为A组、B组,A组给予腔镜下甲状腺癌手术治疗,B组给予传统开放性手术治疗,比较两组手术指标、术后指标、术前及术后SCL-90量表、艾森克人格问卷(Eysenck personality questionnaire,EPQ)评分。结果:A组患者手术时间为(118.34±15.21)min,长于B组的(90.27±18.34)min(P<0.05),出血量、术后引流量少于B组(P<0.05),两组患者淋巴结清扫数目、住院时间差异无统计学意义(P>0.05);A组患者术后不良反应、并发症发生率分别为3.33%、5.00%,低于B组的15.00%、18.33%(P<0.05);术前两组患者SCL-90量表各因子评分差异无统计学意义(P>0.05),术后A组患者SCL量表各因子评分低于B组,且与术前相比B组患者SCL量表各因子评分上升(P<0.05);术前两组患者EPQ问卷各维度评分差异无统计学意义(P>0.05),术后A组患者EPQ问卷评分低于B组,且与术前相比B组患者EPQ问卷评分提高(P<0.05)。结论:对于高龄甲状腺癌患者,腔镜下手术和传统开放性手术相比尽管手术时间较长,但术中出血量及术后引流量较低,且疗效相当,在降低术后不良反应、并发症发生率方面效果更优,尤其是在改善患者心理情绪方面效果显著,但建议采用悬吊法建立手术空间,确保高龄患者呼吸的稳定性。

Objective:To discuss and analyze the application effect of endoscopy in elderly patients with thyroid cancer.Methods:A total of 120 elderly patients with thyroid cancer admitted from September 2018 to September 2019 were randomly divided into groups A and B.Group A was treated with endoscopic thyroid cancer surgery,and group B was treated with traditional open surgery.The surgical indicators,postoperative indicators,preoperative and postoperative SCL-90 scale,and Eysenck personality questionnaire(EPQ)scores were compared between the two groups.Results:The operation time of group A(118.34±15.21)min was significantly higher than that of group B(90.27±18.34)min.The blood loss(15.95±3.21)mL and the postoperative drainage volume(135.07±25.66)ml of group A were significantly reduced(P<0.05),compared with those(36.48±3.30)ml and(80.92±26.13)mL of group B.There was no significant difference in the number of lymph node dissections and length of stay between the two groups(P>0.05);the incidence of adverse reactions(3.33%)and complications(5.00%)in group A were lower than those(15.00%and 18.33%)of group B(P<0.05);there was no statistically significant difference in the scores of each factor of the SCL-90 scale between the two groups before surgery(P>0.05).The scores of each factor of the SCL scale of group A were lower than those of group B,and the scores of each factor of the SCL scale of group B increased compared with preoperative(P<0.05);there was no significant difference in the scores of each dimension of EPQ questionnaire between the two groups before operation Significance(P>0.05),the EPQ questionnaire score of group A patients was lower than that of group B after operation,and the EPQ questionnaire score of group B patients was higher than that before operation(P<0.05).Conclusion:For elderly patients with thyroid cancer,laparoscopic surgery is better than traditional open surgery in the respects of intraoperative blood loss and postoperative drainage.It can reduce the postoperative adverse reactions and complications.The effect is better in terms of the incidence of symptoms,especially in improving the psychological and emotional aspects of patients.However,it is recommended to use the suspension method to establish a surgical space to ensure the stability of the breathing of elderly patients.