甲状腺腺叶切除术对甲状腺结节患者甲状腺激素水平及预后的影响

Effect of thyroid lobectomy on thyroid hormone level and prognosis in patients with thyroid nodule

目的 探讨甲状腺结节患者采用甲状腺腺叶切除术治疗对其甲状腺激素水平及预后的影响.方法 选择2015年5月至2017年5月南阳市中医院收治的甲状腺结节患者98例,将其按盲抽法分为两组,每组49例.对照组采用甲状腺次全切术治疗,观察组采用甲状腺腺叶切除术治疗,随访1个月,比较两组手术相关指标、甲状腺激素水平、并发症发生率.结果 观察组术中出血量（75.65±9.51）ml、手术时间（108.62±10.84）min、术后引流量（50.06±5.14）ml、住院时间（9.65±2.54）d均少于对照组[（112.05±10.31）ml、（146.34±10.03）min、（65.31±5.33）ml、（12.28±3.26）d],差异有统计学意义（P〈0.05）;术后1周,观察组血清促甲状腺激素（TSH）、血清总三碘甲状腺原氨酸（TT3）[（8.03±1.01）mIU/L、（2.26±0.58）nmol/L]高于对照组[（6.32±0.94）mIU/L、（1.93±0.61）nmol/L],血清甲状腺素（TT4）、甲状腺过氧化物酶（TPO）[（87.22±14.34）nmol/L、（62.32±17.33）IU/L]低于对照组[（94.03±16.34）nmol/L、（92.65±18.65）IU/L],差异有统计学意义（P〈0.05）;观察组并发症发生率（9.62％）低于对照组（25.00％）,差异有统计学意义（P〈0.05）.结论 甲状腺结节采用甲状腺腺叶切除术治疗,可减轻机体创伤性,降低并发症发生率,有利于甲状腺功能恢复,改善预后.

Objective To investigate the effect of thyroid lobectomy on thyroid hormone level and prognosis in patients with thyroid nodule .Methods Ninety-eight patients with thyroid nodule in the Nanyang Traditional Chinese Medicine Hospital from May 2015 to May 2017 were selected , and they were divided into two groups by blind selection method , with 49 cases in each group .Control group was given subtotal thyroidectomy , and observation group was treated with thyroid lobectomy .After one-month follow-up, the surgical indexes , thyroid hormone level, incidence of complications were compared between the two groups .Results The intraoperative bleeding volume , operation time , postoperative drainage volume, hospital stays in observation group [（75.65 ±9.51） ml, （108.62 ±10.84） min, （50.06 ±5.14）ml, （9.65 ±2.54）d] were lower than those in control group [（112.05 ±10.31）ml, （146.34 ±10.03）min, （65.31 ±5.33）ml, （12.28 ±3.26）d], P〈0.05; after surgery for 1 week, the TSH and TT3 in observation group [（8.03 ±1.01） mIU/L, （2.26 ±0.58） nmol/L] were higher than those in control group [ （ 6.32 ±0.94 ） mIU/L, （ 1.93 ±0.61 ） nmol/L ] , the TT4 and TPO in observation group [ （ 87.22 ±14.34 ） nmol/L, （ 62.32 ±17.33 ） IU/L ] were lower than than those in control group [ （ 94.03 ±16.34 ） nmol/L, （ 92.65 ±18.65 ） IU/L ] , P〈0.05; the incidence of complications in observation group （ 9.62％） was lower than control group （ 25.00％） , P〈0.05. Conclusions Thyroid lobectomy in treatment of thyroid nodule can reduce trauma , decrease the incidence of complications , recover thyroid function and improve prognosis .