腔镜手术与开放手术对分化型甲状腺癌患者围手术期指标及术后康复影响的对比分析

Comparative Analysis of the Influence of Endoscopic Surgery and Open Surgery on Perioperative Indexes and Postoperative Recovery in Patients with Differentiated Thyroid Carcinoma

目的探讨分化型甲状腺癌(DTC)患者实施腔镜手术与开放手术的效果.方法将我院2020年5月—2022年8月收治的86例DTC患者纳为研究对象,按照随机抽签法分为开放组、研究组,每组43例.开放组实施开放手术,研究组实施腔镜手术.比较两组围手术期指标、疼痛程度、并发症发生情况、生理应激情况.结果两组淋巴结清扫数量比较,差异无统计学意义(P>0.05);但研究组住院时间短于开放组,手术时间长于开放组,术中出血量、术后引流量均少于开放组,组间差异有统计学意义(P<0.05).术后6、12、24、36 h,研究组疼痛视觉模拟评分均低于开放组,组间差异有统计学意义(P<0.05).研究组并发症发生率为9.30%,低于开放组的27.91%,差异有统计学意义(P<0.05).术后第1天,研究组白细胞计数、C-反应蛋白水平均低于开放组,组间差异有统计学意义(P<0.05).结论腔镜手术能减少DTC患者术中出血量和术后引流量,缩短其住院时间,同时能减轻患者术后疼痛和生理应激反应,减少并发症发生,且治疗效果与开放手术相当.

Objective To investigate the effect of endoscopic surgery and open surgery in differentiated thyroid carcinoma(DTC)patients.Methods A total of 86 DTC patients admitted to the hospital from May 2020 to August 2022 were enrolled as study subjects and divided into an open group and a study group according to random drawing method,with 43 cases in each group.Open surgery was performed in the open group and endoscopic surgery was performed in the study group.Perioperative indexes,pain degree,complications and physiological stress were compared between the two groups.Results There was no statistically significant difference in the number of lymph node dissection between the two groups(P>0.05);but the hospital stay of the study group was shorter than that of the open group,the operation time was longer than that of the open group,the intraoperative blood loss and postoperative drainage volume were less than those of the open group,and the differences between the groups were statistically significant(P<0.05).After 6,12,24,36 h,the pain visual analog score of the study group was lower than that of the open group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the study group was 9.30%,which was lower than 27.91%in the open group,and the difference was statistically significant(P<0.05).On the first day after surgery,the white blood cell count and C-reactive protein level in the study group were lower than those in the open group,and the differences between the groups were statistically significant(P<0.05).Conclusion Endoscopic surgery can reduce intraoperative blood loss and postoperative drainage volume in DTC patients,shorten the length of hospital stay,reduce postoperative pain and physiological stress response of patients,and reduce complications,and the therapeutic effect is comparable to that of open surgery.