无充气腋窝入路完全腔镜下手术在甲状腺乳头状癌中的应用效果

Application Effect of Totally Endoscopic Surgery by Axillary Approach without Inflatable in Papillary Thyroid Carcinoma

目的:研究与观察无充气腋窝入路完全腔镜下手术在甲状腺乳头状癌中的应用效果。方法:选取2019年1月-2021年2月的110例甲状腺乳头状癌患者为研究对象,将其根据手术方式分为开放式手术组(对照组)和无充气腋窝入路完全腔镜下手术组(观察组),每组55例。比较两组淋巴结清扫数目、出血量、住院时间、术后不同时间的不适感程度、颈部活动度及手术前后的血清创伤应激指标。结果:两组淋巴结清扫数目、住院时间比较,差异均无统计学意义(P>0.05);但观察组出血量显著少于对照组(P<0.05)。观察组术后1、3、5 d不适感程度均显著优于对照组(P<0.05)。观察组术后1、2周颈部活动均度显著优于对照组(P<0.05)。两组术前血清创伤应激指标比较,差异均无统计学意义(P>0.05);观察组术后1、3、5 d血清创伤应激指标均显著低于对照组(P<0.05)。结论:无充气腋窝入路完全腔镜下手术在甲状腺乳头状癌中的应用效果较好,且对创伤及功能状态的影响相对更好,因此在本类患者中具有更高的应用价值。

Objective:To study and observe the application effect of totally endoscopic surgery by axillary approach without inflatable in papillary thyroid carcinoma.Method:A total of 110 patients with papillary thyroid carcinoma from January 2019 to February 2021 were chosen as the study objects,and they were divided into open surgery group (the control group) and totally endoscopic surgery by axillary approach without inflatable group (the observation group) according to the operation modes,55 cases in each group.Then the number of lymph node dissection,blood loss,hospitalization time,degree of discomfort at different times after surgery,neck activity,serum trauma stress indexes before and after surgery of two groups were compared.Result:The number of lymph node dissection and hospitalization time of two groups were compared,there were no statistically significant differences (P>0.05);but the blood loss of the observation group was significantly less than that of the control group (P<0.05).The degree of discomfort of the observation group at 1,3 and 5 d after surgery were significantly better than those of the control group (P<0.05).The neck activity of the observation group at 1 and 2 weeks after surgery were significantly better than those of the control group (P<0.05).The serum trauma stress indexes of two groups before surgery were compared,there were no statistically significant differences (P>0.05);the serum trauma stress indexes of the observation group at 1,3 and 5 d after surgery were significantly lower than those of the control group (P<0.05).Conclusion:The application effect of totally endoscopic surgery by axillary approach without inflatable in papillary thyroid carcinoma is better,and its influence for trauma and function are relatively better,so its application value in these patients is higher.