撑开式悬吊拉钩协助下行免充气经口腔前庭腔镜下甲状腺切除术对手术效果的影响

The influence of open suspension hook assisted downward non-inflating oral vestibular endoscopic thyroidectomy on surgical effect

目的:探讨撑开式悬吊拉钩协助下行免充气经口腔前庭腔镜甲状腺切除术对患者围术期指标和应激水平的影响。方法:将郑州大学第一附属医院2017年10月—2020年10月收治的100例经口腔前庭腔镜下甲状腺切除术患者作为研究对象,按照随机数字表法分为两组。对照组50例采用混合空间法完成建腔及手术治疗,观察组50例采用撑开式悬吊拉钩协助下行免充气经口腔前庭腔镜下甲状腺手术治疗,观察两组围手术指标、应激指标和并发症情况。结果:观察组术中出血量、术后引流量均低于对照组,引流管留置时间和手术时间均短于对照组(P<0.05)。两组术前动脉血pH值及动脉血二氧化碳(PaCO_(2))水平差异无统计学意义(P>0.05);手术开始后60 min,两组动脉血pH值均较术前升高(P<0.05),对照组PaCO_(2)水平也较术前升高(P<0.05),而观察组术后PaCO_(2)变化不明显(P>0.05);观察组术后动脉血pH值和PaCO_(2)均低于对照组(P<0.05)。观察组并发症发生率(6.00%)明显低于对照组(20.00%,P<0.05)。结论:撑开式悬吊拉钩协助下行免充气口腔前庭腔镜甲状腺手术可显著改善患者手术相关指标及应激水平,同时降低并发症的发生率。

Objective:To investigate the influence of the open suspension hook assisted downward non-inflatable oral vestibular endoscopic thyroidectomy on the perioperative index and stress level of the patient.Methods:A total of 100 patients undergoing oral vestibular endoscopic thyroid surgery in the First Affiliated Hospital of Zhengzhou University from Oct.2017 to Oct.2020 were selected as the research objects.According to the random number table method,they were divided into two groups.A mixed space method was used to complete cavity construction and surgery in 50 cases in the control group.Fifty patients in the observation group were treated by thyroid surgery with the help of an open suspension retractor under a non-inflatable oral vestibular endoscope.Perioperative indicators,stress indicators,and complications were observed in the two groups.Results:The intraoperative blood loss and postoperative drainage volume were lower and the drainage tube indwelling time and operation time were shorter in the observation group than in the control group(P<0.05).There was no significant difference in preoperative arterial blood pH and arterial blood PaCO_(2) between the two groups(P>0.05).The arterial blood pH value was higher at 60 min after operation than that before operation in both groups(P<0.05).PaCO_(2) level in the control group was also higher than that before surgery(P<0.05).PaCO_(2) in the observation group had no significant postoperative changes(P>0.05).The postoperative arterial blood pH and PaCO_(2) in observation group were lower than those in control group(P<0.05).The incidence of complications in observation group(6.00%)was significantly lower than that of control group(20.00%,P<0.05).Conclusions:The open suspension hook-assisted non-inflation oral vestibular endoscopic thyroid surgery can significantly improve the surgery-related indicators and stress levels of patients,while reducing the incidence of complications.