经胸壁入路腔镜辅助甲状腺肿瘤切除术在良性甲状腺肿瘤患者中的应用效果研究

Application of Endoscopic Assisted Thyroidectomy Via Chest Wall Approach in Patients with Benign Thyroid Tumors

目的探讨经胸壁入路腔镜辅助甲状腺肿瘤切除术在良性甲状腺肿瘤(TT)患者中的应用效果。方法选取我院2021年5月—2023年5月收治的70例良性TT患者为研究对象,按随机数字表法将其分为对照组和观察组,每组35例。对照组行低位小切口TT切除术治疗,观察组行胸壁入路腔镜辅助TT切除术治疗。比较两组的手术情况、甲状腺功能、应激指标及并发症。结果观察组手术时间为(84.24±5.36)min,长于对照组的(72.41±5.27)min,术中出血量、术后引流量分别为(15.96±1.47)mL、(55.41±5.13)mL,均少于对照组的(21.52±2.35)mL、(75.69±6.14)mL,切口长度为(2.24±0.35)cm,短于对照组的(4.15±0.49)cm,组间差异有统计学意义(P<0.05)。观察组术后促甲状腺激素水平为(3.05±0.32)mU/L,低于对照组的(4.18±0.41)mU/L,游离甲状腺素、游离三碘甲状腺原氨酸水平分别为(18.02±1.32)pmol/L、(5.24±0.88)pmol/L,均高于对照组的(16.45±1.23)pmol/L、(4.43±0.61)pmol/L,组间差异有统计学意义(P<0.05)。观察组术后皮质醇、去甲肾上腺未水平分别为(173.59±13.74)μg/L、(205.14±20.58)ng/L,均低于对照组的(202.25±15.75)μg/L、(227.43±22.84)ng/L,组间差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论经胸壁入路腔镜辅助TT切除术治疗良性TT效果更佳,可减轻手术创伤,保护甲状腺功能,且并发症少。

Objective Exploring the application effect of transthoracic endoscopic assisted thyroidectomy in patients with benign thyroid tumors(TT).Methods Selecting 70 benign thyroid tumors patients admitted to our hospital from May 2021 to May 2023 as the research subjects,divided into a control group and an observation group using a random number table method,with 35 cases in each group.The control group underwent low position small incision TT resection for treatment,Observation group underwent thoracoscopic assisted thyroidectomy through the chest wall approach for treatment of thyroid tumors.Compare the surgical conditions,thyroid function,stress indicators,and complications between two groups.Results The surgical time of the observation group was(84.24±5.36)min,which was longer than that of the control group(72.41±5.27)minutes.The intraoperative bleeding volume and postoperative drainage volume were(15.96±1.47)mL and(55.41±5.13)mL,which were less than(21.52±2.35)mL and(75.69±6.14)mL of the control group,respectively.The incision length was(2.24±0.35)cm,which was shorter than(4.15±0.49)cm of the control group,the difference between groups were statistically significant(P<0.05).The postoperative TSH level in the observation group was(3.05±0.32)mU/L,which was lower than the control group's(4.18±0.41)mU/L.The FT4 and FT3 levels were(18.02±1.32)pmol/L and(5.24±0.88)pmol/L,which were higher than the control group's(16.45±1.23)pmol/L and(4.43±0.61)pmol/L,the difference between groups is statistically significant(P<0.05).The postoperative Cor and NE levels in the observation group were(173.59±13.74)μg/L,(205.14±20.58)ng/L,lower than the control group's(202.25±15.75)μg/L,(227.43±22.84)ng/L,the difference between groups is statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference between the groups was statistically significant(P<0.05).Conclusion Endoscopic assisted thyroidectomy via chest wall approach for the treatment of benign thyroid tumors is more effective,reducing surgical trauma,protecting thyroid function,and having fewer complications.