全切与近全切手术治疗甲状腺癌的临床疗效比较

Comparison of Clinical Effects of Total and Near Total Resection in the Treatment of Thyroid Cancer

目的研究全切手术和近全切手术治疗甲状腺癌的疗效。方法随机选取2015年11月—2020年11月该院收治的甲状腺癌患者76例,依据不同治疗术式分为两组,各38例。对照组给予全切手术治疗,观察组给予近全切手术治疗,对比两组疗效。结果对照组手术时间(1.35±0.16)h,术中出血量(238.26±25.14)mL,住院时间(8.19±0.27)d,观察组手术时间(1.02±0.12)h,术中出血量(148.52±22.36)mL,住院时间(6.20±0.38)d,两组对比差异有统计学意义(t=3.152、56.317、3.389,P<0.05)。治疗后对照组血清Ca^(2+)(1.05±0.10)mmol/L,PTH(10.15±0.09)pg/mL,SF-36(72.53±2.85)分,观察组血清Ca^(2+)(1.92±0.16)mmol/L,PTH(17.15±0.16)pg/mL,SF-36(81.21±4.65)分,两组对比差异有统计学意义(t=5.146、5.748、5.493,P<0.05)。对照组甲状腺功能受损2例(5.26%),声音嘶哑3例(7.89%),低钙血症1例(2.63%),喉返神经损伤2例(5.26%),感染1例(2.63%),合计9例(23.68%),观察组声音嘶哑1例(2.63%),甲状腺功能受损、低钙血症、喉返神经损伤、感染0例(0.00%),合计1例(2.63%),两组对比差异有统计学意义(χ^(2)=5.394,P<0.05)。对照组治疗有效率为100.00%(38/38),观察组治疗有效率为97.37%(37/38),两组对比差异无统计学意义(χ^(2)=0.000,P>0.05)。结论对甲状腺癌患者采取近全切手术治疗具有突出优势,有利于缩短手术治疗时间,减少术中出血量,对患者生理功能影响较小,术后出现的并发症少,有利于减少对患者生活质量的影响,具有较高推广应用价值。

Objective To study the curative effect of total resection and near total resection in the treatment of thyroid cancer.Methods 76 patients with thyroid cancer treated in the hospital from November 2015 to November 2020 were randomly selected and divided into two groups according to different treatment methods,38 cases in each group.The control group was treated with total resection and the observation group was treated with near total resection.The curative effects of the two groups were compared.Results In the control group,the operation time was(1.35±0.16)h,the intraoperative blood loss was(238.26±25.14)mL,and the hospital stay was(8.19±0.27)d.In the observation group,the operation time was(1.02±0.12)h,the intraoperative blood loss was(148.52±22.36)mL,and the hospital stay was(6.20±0.38)d,the difference between the two groups was statistically significant(t=3.152,56.317,3.389,P<0.05).In the control group,after the reatment,the serum Ca^(2+)(1.05±0.10)mmol/L,PTH(10.15±0.09)pg/mL,SF-36(72.53±2.85)points.The serum Ca^(2+)(1.92±0.16)mmol/L,PTH(17.15±0.16)pg/mL and SF-36(81.21±4.65)points in the observation group,the difference between the two groups was statistically significant(t=5.146,5.748,5.493,P<0.05).In the control group,there were 2 cases of impaired thyroid function(5.26%),3 cases of hoarseness(7.89%),1 case of hypocalcemia(2.63%),2 cases of recurrent laryngeal nerve injury(5.26%),and 1 case of infection(2.63%),a total of 9 cases(23.68%).In the observation group,there were 1 case of hoarseness(2.63%),0 cases of thyroid function impairment,hypocalcemia,recurrent laryngeal nerve injury and infection(0.00%),a total of 1 case(2.63%),the difference between the two groups was statistically significant(χ^(2)=5.394,P<0.05).The effective rate of treatment in the control group was 100.00%(38/38).The effective rate of treatment in the observation group was 97.37%(37/38),the difference between the two groups was not statistically significant(χ^(2)=0.000,P>0.05).Conclusion Adopting near-total surgical treatment for patients with thyroid cancer has outstanding advantages,which is beneficial to shorten the surgical treatment time,reduce the amount of intraoperative blood loss,and have little impact on the physiological functions of the patients.There are fewer complications after surgery,which is beneficial to reduce the impact on the quality of life of patients,and has a high value for promotion and application.