无充气经腋窝入路腔镜手术治疗早期甲状腺肿瘤疗效及对患者免疫功能和美学效果的影响

Efficacy of non-inflatable transaxillary approach laparoscopic surgery in treatment of early thyroid neoplasms and its effect on immune function and aesthetic effect

目的:探讨无充气经腋窝入路腔镜手术治疗早期甲状腺肿瘤的疗效及对患者免疫功能和美学效果的影响。方法:选择早期甲状腺肿瘤患者76例随机均分为两组,研究组采用无充气经腋窝入路腔镜手术治疗,对照组行经胸乳入路腔镜手术治疗,对比观察两组患者的临床疗效、免疫功能和美学效果。结果:研究组患者术中出血量、取标本时间和术后引流体积等指标均明显少于对照组(P<0.05);治疗前两组患者各项指标比较差异无统计学意义(P>0.05),治疗后两组患者CD4+、CD3+和CD4+/CD8+水平均明显降低,CD8+水平明显升高,研究组变化程度均明显小于对照组(P<0.05);研究组患者美容效果满意度明显高于对照组(P<0.05);两组术后并发生发生率比较无统计学差异(P>0.05)。结论:无充气经腋窝入路腔镜手术治疗早期甲状腺瘤手术效果更佳,患者免疫功能指标改善程度和美容满意度均明显优于经胸乳入路腔镜手术治疗的患者。

Objective:To investigate the efficacy of non-inflatable transforaminal laparoscopic surgery in the treatment of early thyroid tumors and its effect on immune function and aesthetic effect.Methods:76 patients with early thyroid tumors were divided into two groups.The study group was treated with non-inflatable transaxillary approach endoscopic surgery,and the control group was treated with endoscopic surgery via thoracolumbar approach.The clinical efficacy,immune function and aesthetic effect of the two groups were observed and compared.Results:The intraoperative blood loss,specimen time and postoperative drainage volume in the study group were significantly lower than those in the control group(P<0.05).Before treatment,there was no significant difference in various indicators between the two groups(P>0.05).After treatment,CD4+,CD3+ and CD4+/CD8+ levels in the two groups were significantly decreased,while CD8+ level was significantly increased.The changes in the study group were significantly smaller than those in the control group(P<0.05).The satisfaction of the study group was 89.47%,which was significantly higher than that of the control group(71.05%)(P<0.05).There was no statistical difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:The efficacy of non-inflatable transaxillary approach laparoscopic surgery in the treatment of early thyroid tumors are better.The improvement of immune function indexes and cosmetic satisfaction are better than those of patients underwent endoscopic surgery via thoracolumbar approach.