达芬奇机器人辅助外科行甲状腺次全切除术效果观察

Da Vinci robot-assisted surgery for benign thyroid nodules

目的:观察达芬奇机器人手术系统行甲状腺次全切除术临床效果。方法:回顾性分析2018年1月-2019年3月甲状腺良性结节患者75例,根据手术方式将患者分为两组:机器人组41例,结节性甲状腺肿37例,甲状腺肿腺瘤4例,男、女分别为5和36例,平均年龄(48.49±10.28)岁;平均BMI 22.98±2.65,平均肿瘤直径(2.79±1.39)cm。传统组34例,结节性甲状腺肿28例,甲状腺肿腺瘤6例,男、女分别为2和32例,平均年龄(51.91±9.15)岁;平均BMI值23.63±2.78,平均肿瘤直径(3.01±1.41)cm。分析两组患者的手术指标、并发症率、术后1周及1月的美容评分、术前及术后24 h的肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白细胞介素6(IL-6)水平。结果:与传统组相比,机器人组切口长度小、术中出血量少、切口美容评分好、手术时间长和住院费用多(P<0.05),机器人组并发症发生率明显低于传统组(P<0.05),两组患者术前CRP、TNF-α及IL-6水平均无统计学差异(P>0.05),同组术后均较术前明显增加(P<0.05);传统组较机器人组升高更显著(P<0.05)。结论:与传统手术相比,达芬奇机器人行甲状腺次全切除术效果更为显著,降低并发症率及炎症反应,提高患者美容满意度。

Objective:To observe the clinical application of Da Vinci robotic surgical system in the treatment of benign thyroid nodules.Methods:A retrospective analysis was performed on 75 patients with benign thyroid nodules from January 2018 to March 2019.The patients were divided into two groups according to the surgical method:41 cases in the Da Vinci group,37 cases of nodular goiter,4 cases of goiter adenoma,5 and 36 cases of male and female,mean age(48.49±10.28)Years;average BMI value(22.98±2.65)kg/m2,average tumor diameter(2.79±1.39)cm;34 cases in traditional group,28 cases of nodular goiter,6 cases of goiter adenoma,male and female respectively 2.In 32 cases,the average age was(51.91±9.15)years;the average BMI was(23.63±2.78)kg/m2,and the average tumor diameter was(3.01±1.41)cm.Surgical indicators,complication rate,beauty scores at 1 week and 1 month,tumor necrosis factorα(TNF-α),C-reactive protein(CRP),and interleukin Element 6(IL-6).Results:Compared with the traditional group,the robot group had smaller incision length,less intraoperative bleeding,cosmetic incision score,longer operation time,and more hospitalization costs.The differences between the groups were statistically significant(P<0.05).Complications occurred in the robot group.The rate was significantly lower than that in the traditional group(P<0.05).There was no statistical difference in CRP,TNF-α,and IL-6 before surgery in the two groups(P>0.05),and the postoperative rate in the same group was significantly increased compared with before surgery(P<0.05);and the traditional group was more significant than the robot group(P<0.05).Conclusion:Compared with traditional surgery,Da Vinci robotic surgery is more effective in treating benign thyroid nodules.It reduces the complication rate and inflammatory response,improves the patient's cosmetic satisfaction,and is worthy of clinical promotion and application.