经腋窝入路单孔腔镜手术对甲状腺肿瘤患者应激代谢的影响

目的：评估单孔腔镜手术对甲状腺肿瘤患者机体应激及代谢的影响。方法选择2008年1月至2015年6月甲状腺肿瘤患者400例，随机方式分为单孔腔镜组（n=188）与传统腔镜组（n=212）。分别检测术前48h、术后24h、144h血清中甲状腺激素（T3，T4，TSH）水平并比较。结果两组患者术后T3、T4、TSH均有不同变化，两种手术方式在单侧甲状腺切除T3、T4术后24h有所增高，但单孔组恢复较快；传统组双侧甲状腺全切术后24h甲状腺激素（T3，T4，TSH）水平变化较显著，单孔组手术后甲状腺相关激素水平比传统组下降轻微且恢复较快（P〈0.05）。单孔组手术时间长于传统组（P〈0.05）。结论单孔腔镜手术较传统腹腔镜手术对机体应激及代谢影响小。

ObjectiveTo evaluate the effects of single-incisional laparoscopic surgery on the metabolism and stress in the treatment of thyroid cancer.Methods between January 2008 and June 2008,400 cases of thyroid cancer patients weredivided into the single incisional laparoscopic surgery group in a nonrandom manner（n=188）and the traditional laparoscopic surgery group（n=212）. Serum thyroid hormone（T3,T4,TSH） level was detected at the time points of preoperative,postoperative 24 hours,48 hours 144 hours, respectively. Results Two groups of patients with postoperative T3,T4,TSH has different change,two kinds of operation methods in unilateral thyroid resection of T3,T4 higher after 24 hours,but the single-incisional laparoscopic surgery group restore faster;thyroid hormone（T3,T4,TSH）level changes significantly at 24 hours postoperatively in traditional group of bilateral total thyroidectomy,thyroid related hormone levels down slightly in the single-incisional group compared with the traditional group and patients recovered faster. Operating time was longer in single-incisional group than the traditional group.Conclusion The single-incisional laparoscopic surgery has less effect on body＇s stress and metabolism than traditional laparoscopic surgery.