开放与全腔镜下甲状腺癌根治术的疗效比较

Comparison on effects of open versus total laparoscopic radical resection of thyroid cancer

目的:比较开放与全腔镜下甲状腺癌根治术的临床疗效。方法:抽取2018年11月至2020年10月于中国人民解放军联勤保障部队第九八八医院治疗的80例甲状腺癌患者,按照随机数字表法将其分为观察组与对照组,每组40例。观察组采取全腔镜下甲状腺癌根治术,对照组采取开放甲状腺癌根治术。比较两组手术相关指标、应激指标及术后并发症发生情况。结果:观察组术中出血量、术后24 h视觉模拟评分法(VAS)评分低于对照组,住院时间短于对照组(P<0.05)。两组淋巴结清扫个数比较差异未见统计学意义(P>0.05)。术后72 h,观察组白细胞介素-6、C反应蛋白、白细胞计数水平均低于对照组(P均<0.05)。观察组术后手脚麻木(2.5%,1/40)、饮水呛咳(0.0%,0/40)发生率低于对照组(17.5%,7/40;10.0%,4/40),P<0.05。结论:全腔镜下甲状腺癌根治术对患者的创伤更小,患者术后恢复更快、应激反应稍轻、术后并发症更少,应用效果良好。

Objective To compare the effects of open and total laparoscopic radical resection of thyroid cancer.Methods A total of 80 patients with thyroid cancer treated in the 988th Hospital of the Chinese People’s Liberation Army Zhengzhou Joint Logistics Support Force from November 2018 to October 2020 were selected,and they were divided into observation group and control group by random number table method,with 40 cases in each group.Patients in the observation group underwent total laparoscopic radical resection of thyroid cancer;and patients in the control group underwent open radical resection of thyroid cancer.The operation-related indicators,stress indicators,and postoperative complications of the two groups were compared.Results The intraoperative blood loss and the 24-h visual analogue scale(VAS)score of the observation group were significantly lower than those of the control group,and the hospital stay was shorter than that of the control group(P<0.05).There was no significant difference in the number of dissected lymph node between the two groups(P>0.05).The levels of interleukin-6,C reactive protein,and white blood cell count of the observation group were significantly lower than those of the control group 72 h after treatment(all P<0.05).The incidences of postoperative numbness in hands and feet(2.5%,1/40),and water coughing(0.0%,0/40)in the observation group were significantly lower than those of the control group(17.5%,7/40;10.0%,4/40),P<0.05.Conclusions Total laparoscopic radical resection of thyroid cancer has less impact on patients,treated by which patients recover faster after surgery,have less stress response,and have fewer postoperative complications.The application effect is good.