经胸入路腔镜甲状腺切除术治疗甲状腺结节患者的临床效果

Clinical Effect of Transthoracic Endoscopic Thyroidectomy for Treating Patients with Thyroid Nodules

目的探讨经胸入路腔镜甲状腺切除术治疗甲状腺结节患者的临床效果。方法选择2018年1月至2021年6月医院收治的85例甲状腺结节患者作为研究对象,按照随机数字表法分为对照组(42例)与试验组(43例)。对照组给予常规甲状腺切除术,试验组给予经胸入路腔镜甲状腺切除术,比较两组手术一般情况(切口长度、术中出血量、术后引流量及住院时间)、免疫功能[免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)]及术后并发症(继发出血、喉返神经麻痹、低钙抽搐、切口粘连及吞咽不适等)发生情况。结果试验组切口长度及住院时间均短于对照组,术中出血量及术后引流量均少于对照组,差异有统计学意义(P<0.05)。术前,两组血清IgM、IgG及IgA水平比较,差异均无统计学意义(P>0.05);术后第3天,两组血清IgM、IgG及IgA水平均低于术前,但试验组均高于对照组,差异有统计学意义(P<0.05)。试验组术后并发症发生率为9.30%,低于对照组的26.19%,差异有统计学意义(P<0.05)。结论经胸入路腔镜甲状腺切除术治疗甲状腺结节患者可减轻手术创伤,加速康复进程,促进术后免疫功能建立,且可降低术后并发症发生风险。

Objective The clinical effect of transthoracic endoscopic thyroidectomy for treating patients with thyroid nodules was investigated.Methods 85 patients with thyroid nodules admitted to the hospital from January 2018 to June 2021 were selected as the study objects and they were divided into a control group(42 cases)and an experiment group(43 cases)according to the random number table method.The control group received routine thyroidectomy,while the experiment group received transthoracic endoscopic thyroidectomy.The general condition of operation(incision length,intraoperative bleeding volume,postoperative drainage volume and hospital stay),immune function[immunoglobulin M(IgM),immunoglobulin G(IgG)and immunoglobulin A(IgA)]and postoperative complications(secondary bleeding,recurrent laryngeal nerve paralysis,low-calcium convulsion,incision adhesion and swallowing intolerance)were compared between the two groups.Results The incision length and hospital stay of the experiment group were both shorter than those of the control group,and the intraoperative bleeding volume and postoperative drainage volume of the experiment group were both less than those of the control group,with statistically significant differences(P<0.05).Before operation,there was no significant difference in the IgM,IgG and IgA levels in serum of the two groups(P>0.05);3 days after operation,the IgM,IgG and IgA levels in serum of the two groups were all lower than those before operation,but they were higher in the experiment group than those in the control group,with statistically significant differences(P<0.05).The incidence of postoperative complications in the experiment group(9.30%)was lower than that in the control group(26.19%),with statistically significant difference(P<0.05).Conclusion Transthoracic endoscopic thyroidectomy can relieve operation wound,accelerate recovery process,promote the establishment of postoperative immune function,and reduce the risks of postoperative complications in treating patients with thyroid nodules.