甲状腺次全切术治疗对甲状腺多发结节患者甲状腺功能、WBC、CRP水平及生活质量的影响

Effects of Subtotal Thyroidectomy on Thyroid Function,WBC,CRP Levels and Quality of Life in Patients with Multiple Thyroid Nodules

目的探讨甲状腺多发结节患者给予甲状腺次全切术(ST)治疗对甲状腺功能、白细胞计数(WBC)、C反应蛋白(CRP)水平及生活质量的影响。方法选取2020年8月至2021年7月邓州市穰东镇卫生院收治的共计88例甲状腺多发结节患者,按照随机数字表法分成观察组(44例)与对照组(44例),对照组给予甲状腺全切术(TT)治疗,观察组给予ST治疗,比较两组围术期指标、甲状腺功能、WBC、CRP水平、生活质量及并发症发生率。结果观察组与对照组相比手术时间、切口长度更短,差异有统计学意义(P<0.05),术中出血量、镇痛药使用量更少,差异有统计学意义(P<0.05);两组术后7 d促甲状腺激素(TSH)水平提高,差异有统计学意义(P<0.05),游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平降低,差异有统计学意义(P<0.05),但观察组与对照组相比TSH水平更低,差异有统计学意义(P<0.05),FT3、FT4水平更高,差异有统计学意义(P<0.05);两组术后3 d WBC、术后3 d CRP水平提高,差异有统计学意义(P<0.05),但观察组与对照组相比更低,差异有统计学意义(P<0.05);两组术后1个月简明健康调查问卷(SF-36)评分较术前提高,差异有统计学意义(P<0.05),观察组与对照组相比更高,差异有统计学意义(P<0.05);观察组(2.27%)与对照组(15.91%)相比并发症发生率更低,差异有统计学意义(P<0.05)。结论甲状腺多发结节患者给予ST治疗,能够改善围术期指标,调节WBC、CRP水平,提高患者生活质量,降低并发症发生率,对甲状腺功能影响较小。

Objective To investigate the effect of subtotal thyroidectomy(ST)on thyroid function,white blood cell count(WBC),C-reactive protein(CRP)level and quality of life in patients with multiple thyroid nodules.Methods A total of 88patients with multiple thyroid nodules who were admitted in Rangdong Town Health Center in Dengzhou City from August 2020to July 2021 were selected,and they were divided into the observation group(44 cases)and the control group(44 cases)by the randomly number table method.The control group was given total thyroidectomy(TT)treatment,and the observation group was given ST treatment.The perioperative indexes,thyroid function,WBC,CRP levels,quality of life and complication rates of the two groups were compared.Results In comparision with the control group,the operation time and incision length of the observation group were shorter(P<0.05),and the intraoperative blood loss and analgesic usage were lower(P<0.05).At 7 days after surgery,the levels of thyroid-stimulating hormone(TSH)in the two groups were increased(P<0.05),while the levels of free triiodothyronine(FT3)and free thyroxine(FT4)were decreased(P<0.05),but in comparision with the control group,the level of TSH in the observation group was lower(P<0.05),and the levels of FT3 and FT4 were higher(P<0.05).At 3 days after surgery,the levels of WBC and CRP in the two groups were increased(P<0.05),but the observation group was lower than that in the control group(P<0.05).At 1 month after surgery,the scores of the Simple Health Questionnaire(SF-36)in the two groups were improved than before surgery(P<0.05),and in comparision with the control group,the observation group was higher(P<0.05).The complication rate in the observation group(2.27%)was lower than that in the control group(15.91%)(P<0.05).Conclusion ST treatment for patients with multiple thyroid nodules can improve perioperative indicators,regulate WBC and CRP levels,improve patients’quality of life,reduce the incidence of complications,and have little effect on thyroid function.