腔镜甲状腺手术对患者创伤应激的影响

The trauma and stress reaction following endoscopic thyroidectomy

目的:探讨腔镜甲状腺手术对患者机体创伤应激的影响。方法:62例腔镜甲状腺手术患者按手术顺序分为A组25例,B组37例,分别与同期40例开放甲状腺手术(C组)对比,分析围手术期白细胞(white blood cell,WBC)、C反应蛋白(C reactive protein,CRP)、白介素-6(interleukin-6I,L-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)等炎症因子水平的差异。结果:A组术前及术后第1天、第3天WBC、CRP和IL-6水平与C组相比差异无统计学意义(P>0.05),术后第1天TNF-α水平显著高于C组(P<0.05)。B组术前及术后第1天、第3天WBC水平与C组的差异无统计学意义(P>0.05),术后第1天CRPI、L-6和TNF-α水平显著低于C组(P<0.05),术后第3天CRP水平仍显著低于C组(P<0.05)。结论:随着学习曲线上升,患者机体对腔镜甲状腺手术创伤的应激反应逐渐降低,体现出腔镜甲状腺手术的微创优势。

Objective： To evaluate the trauma and stress reaction following endoscopic thyroidectomy. Methods：The 62 patients who underwent endoscopic thyroidectomy were divided into group A（25 cases） and group B（37 cases） according to the chronological order.Group C（40 cases） underwent open thyroidectomy during the same time were compared with them respectively.White blood cell（WBC）,C reactive protein（CRP）,interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） in peripheral blood were counted and compared on the day before operation,1st and 3rd day after operation. Results：There was no significant difference in WBC,CRP and IL-6 on the day before operation,1st and 3rd day after operation between the group A and group C（P〈0.05）,but the level of TNF-α on the 1st day after operation in group A was significantly higher than group C（P〈0.05）.There was no significant difference in WBC on the day before operation,1st and 3rd day after operation between the group B and group C（P〈0.05）,but the level of CRP,IL-6,TNF-α on the 1st day after operation in group B was significantly lower than group C（P〈0.05）,and the level of CRP on the 3rd day after operation in group B was still significantly lower than group C. Conclusions：As the rising of the learning curve,endoscopic thyroidectomy may gradually reduce the stress reaction,show more advantages of minimally invasive surgery.