腔镜下经乳晕双通道手术治疗甲状腺良性肿瘤的效果分析

Effects of endoscopic double-channel surgery via the breast areola approach for benign thyroid tumor

目的分析对甲状腺良性肿瘤使用腔镜下经乳晕双通道手术治疗的效果。方法50例甲状腺良性肿瘤患者,随机分为研究组与参照组,各25例。参照组接受常规开放性甲状腺手术治疗,研究组接受腔镜下经乳晕双通道手术治疗。对比两组治疗前后焦虑、抑郁、疼痛、数字评分系统评分、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)]水平及并发症发生情况、临床指标。结果治疗后,研究组焦虑自评量表(SAS)、抑郁自评量表(SDS)、视觉模拟评分法(VAS)评分分别为(45.76±4.48)、(44.85±6.84)、(1.76±0.48)分,均低于参照组的(51.76±5.87)、(52.21±4.76)、(2.12±0.51)分,数字评分系统(NSS)评分(5.87±0.84)分高于参照组的(3.12±0.75)分,差异均有统计学意义(P<0.05)。治疗后,研究组TNF-α、IL-6、hs-CRP水平分别为(15.52±2.78)ng/ml、(13.82±3.81)pg/ml、(10.91±1.42)mg/L,均低于参照组的(25.84±4.26)ng/ml、(26.35±2.92)pg/ml、(23.82±3.21)mg/L,差异均有统计学意义(P<0.05)。研究组术中出血量(10.00±5.00)ml、手术时间(72.08±9.94)min、引流时间(1.31±0.19)d、引流量(68.78±9.65)ml、住院时间(5.28±1.32)d均优于参照组的(20.89±5.18)ml、(94.85±10.08)min、(2.72±0.32)d、(98.78±12.18)ml、(8.25±1.87)d,差异均有统计学意义(P<0.05)。研究组并发症发生率为12.00%,低于参照组的36.00%,差异有统计学意义(P<0.05)。结论使用腔镜下经乳晕双通道手术治疗甲状腺良性肿瘤,对炎症反应刺激较小,手术方法安全、创伤小,可减轻患者的疼痛感,美观性较高,可广泛应用在甲状腺良性肿瘤治疗中。

Objective To investigate the effect of endoscopic double-channel surgery via the breast areola approach for benign thyroid tumor.Methods 50 patients with benign thyroid tumor were randomly divided into a study group and a control group,with 25 cases in each group.Patients in the control group received conventional open thyroid surgery,and patients in the study group received endoscopic double-channel surgery via the breast areola approach.The anxiety,depression,pain,scores of numerical scoring system,levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high sensitive C-reactive protein(hs-CRP)]before and after the treatment,complications and clinical indicators were compared between the two groups.Results After the treatment,the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS)and visual analogue scale(VAS)of the study group were(45.76±4.48)points,(44.85±6.84)points and(1.76±0.48)points,respectively,which were lower than(51.76±5.87),(52.21±4.76)and(2.12±0.51)points of the control group;the score of numerical scoring system(NSS)of the study group was(5.87±0.84)points,which was higher than(3.12±0.75)points of the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of TNF-α,IL-6 and hs-CRP of the study group were(15.52±2.78)ng/ml,(13.82±3.81)pg/ml and(10.91±1.42)mg/L,respectively,which were lower than(25.84±4.26)ng/ml,(26.35±2.92)pg/ml and(23.82±3.21)mg/L of the control group,respectively;and the differences were statistically significant(P<0.05).The study group had an intraoperative bleeding amount of(10.00±5.00)ml,an operation time of(72.08±9.94)min,a drainage time of(1.31±0.19)d,a drainage volume of(68.78±9.65)ml and a hospital stay of(5.28±1.32)d,which were better than(20.89±5.18)ml,(94.85±10.08)min,(2.72±0.32)d,(98.78±12.18)ml,(8.25±1.87)d of the control group,respectively;and the differences were statistically significant(P<0.05).The incidence of complications of the study group was 12.00%,which was lower than 36.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of benign thyroid tumor,endoscopic double-channel surgery via the breast areola approach shows less stimulation of inflammatory reaction,high safety,less trauma,less pain and high aesthetics.Therefore,it can be widely applied in the treatment of benign thyroid tumor.