腔镜辅助与完全腔镜下甲状腺手术创伤应激反应的对照研究

Comparative study of stress reaction between minimally invasive endoscopic-assisted thyroidectomy and totally endoscopic thyroidectomy

目的:分析对比完全腔镜甲状腺手术与腔镜辅助甲状腺手术的创伤应激反应及微创效果。方法:95例患者行腔镜辅助甲状腺手术(辅助组),58例行完全腔镜甲状腺手术(完全组),观察对比两组患者手术前后的应激创伤指标IL-6、TNF-α、CRP。结果:手术后第1天,两组患者IL-6、TNF-α、CRP均明显上升,与术前相比差异有统计学意义(P<0.05);第3天明显下降,但仍高于术前水平,差异有统计学意义(P<0.05)。但两组手术前后各指标差异无统计学意义(P>0.05)。结论:腔镜辅助与完全腔镜甲状腺手术并发症发生率相似,微创效果均较好,术者应根据患者具体情况选择相应术式。

Objective： The aim of this study is to analyze and compare the traumatic stress reaction and minimally invasive effect between minimally invasive video-assisted thyroidectomy（ MIVAT） and totally endoscopic thyroidectomy（ ET）. Methods： MIVAT group included 95 patients,ET group contained 58 cases,their perioperative clinic results and trauma indices（ IL-6,CRP,TNF-α）were observed and compared. Results： All patients received general anesthesia. The result of IL-6,TNF-α,CRP of postoperative first day were higher than before operation（ P 〈0. 05）. The result of IL-6,TNF-α,CRP reduced quickly on postoperative third day but still higher than before operation（ P〈 0. 05）. But no significant differences were found between the two groups（ P 〉0. 05）. Conclusions： MIVAT and ET are feasible,safe and promising in selected patients,with similar complication incidence and favorable mini-invasive effect. Both of these two methods can achieve good minimal invasive effect,surgeons should choose appropriate surgical procedure according to patients＇ conditions.