经胸乳入路腔镜在甲状腺良性肿瘤中的应用及对甲状旁腺激素和血清钙的影响

Value of transthoracic approach endoscopy in operation of benign thyroid tumors and influence on levels of parathyroid hormone and serum calcium

目的比较甲状腺良性肿瘤采用传统甲状腺手术与经胸乳入路腔镜甲状腺手术的疗效。方法选取2019年2月至2020年3月濮阳市油田总医院收治的80例甲状腺良性肿瘤患者,根据手术方式的不同随机分为两组,对45例采用传统开放性甲状腺手术治疗者设为对照组,另外接受经胸乳入路腔镜手术治疗的35例患者作为观察组,比较两组术中情况、术后恢复情况与并发症发生率。结果经胸乳入路腔镜手术观察组与对照组比较,手术时间更长,术后引流时间和住院时间更短(P<0.05),术中出血量更少(P<0.05),术后1 d视觉模拟评分(VAS)观察组为(4.02±0.86)分,少于对照组[(6.11±1.58)分],组间差异有统计学意义(P<0.05);与术前相比,术后3d对照组血清钙水平及两组患者甲状旁腺激素水平均显著降低;观察组术后第3 d的甲状旁腺激素及血清钙水平与对照组比较,均增高(P<0.05);观察组术后并发症发生率(5.71%)低于对照组(22.22%),差异有统计学意义(P<0.05)。结论经胸乳入路腔镜甲状腺手术在甲状腺良性肿瘤治疗中能使甲状旁腺激素与血清钙浓度维持稳定,手术创伤显著减轻,并缩短住院时间,安全性高,应用效果好。

Objective To compare the efficacy of traditional thyroid surgery for benign thyroid tumors and endoscopic thyroidectomy through the thoracolagal approach. Methods Selected From February 2019 to March 2020 in puyang oil field general hospital treated 80 cases of patients with thyroid benign tumor, 45 cases of control group adopts the traditional open thyroid surgery, in addition to accept the breast into therapeutic endoscopy surgery 35 patients as observation group, comparing two groups of intraoperative and postoperative recovery and complications. Results The breast into the observation group endoscopy surgery compared with the traditional open thyroid surgery controls, longer operation time, postoperative drainage time and shorter hospital stay(P<0.05), less intraoperative blood loss(P<0.05), postoperative 1 dvas score group is(4.02±0.86) points, less than the control group(6.11±1.58), difference between groups was statistically significant(P<0.05);Compared with the preoperative level, the serum calcium level in the control group and the parathyroid hormone level in the two groups were significantly reduced after 3 d traditional open thyroid surgery. were higher in the observation group through thoracoscopic surgery on the third day after operation than in the control group through traditional open thyroid surgery(P<0.05). Compared with the control group of traditional open thyroid surgery, the incidence of postoperative complications in the observation group of endoscopic thoracic surgery was 5.71%, lower than that of the control group(22.22%)(P<0.05). Conclusion Endoscopic thyroidectomy via thoracolumbar approach in the treatment of benign thyroid tumors can maintain the stability of parathyroid hormone and serum calcium concentration, significantly reduce the surgical trauma, and shorten the hospital stay, with high safety and good application effect.