微波消融术在甲状腺结节中的疗效及对创伤应激状态的影响

Effect of Microwave Ablation in the Treatment of Patients with Thyroid Nodule and Its Influence on Traumatic Stress State

目的:探究及观察微波消融术在甲状腺结节中的疗效及对创伤应激状态的影响。方法:选取2020年1月-2022年1月厦门大学附属第一医院收治的100例甲状腺结节患者,根据随机数字表法将其分为对照组50例和观察组50例。对照组进行甲状腺切除术,观察组则进行微波消融术。比较两组结节清除率、手术时间、术中出血量、总并发症发生率、住院时间、美观程度评分、满意度、局部不适感程度及创伤应激指标[血清白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、细胞免疫指标(CD3^(+)、CD4^(+)及CD8^(+))]。结果:观察组结节清除率及总满意度均高于对照组,并发症发生率低于对照组,手术时间及住院时间均短于对照组,术中出血量少于对照组,美观程度评分高于对照组,差异均有统计学意义(P<0.05)。术前,两组血清IL-1β、TNF-α、CD3^(+)、CD4^(+)、CD8^(+)比较,差异均无统计学意义(P>0.05);术后3、5 d,观察组血清IL-1β、TNF-α、CD8^(+)均低于对照组,观察组CD3^(+)及CD4^(+)均高于对照组,差异均有统计学意义(P<0.05)。术前,两组局部不适感评分比较,差异无统计学意义(P>0.05);术后12、24及48 h,观察组局部不适感评分均低于对照组,差异均有统计学意义(P<0.05)。结论:微波消融术在甲状腺结节中的疗效较好,可有效控制创伤应激状态,因此在甲状腺结节患者中的应用价值相对更高。

Objective:To investigate and observe the effect of microwave ablation in the treatment of patients with thyroid nodule and its influence on traumatic stress state.Method:A total of 100 patients with thyroid nodule in the First Affiliated Hospital of Xiamen University from January 2020 to January 2022 were selected,they were divided into control group(50 cases)and observation group(50 cases)according to the random number table.The control group was treated with thyroidectomy,the observation group was treated with microwave ablation.Then the nodule clearance rates,operation time,intraoperative blood loss,total complication rates,hospitalization time,aesthetic score and satisfaction,local discomfort degree and traumatic stress indexes[serum interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),cellular immune indicators(CD3^(+),CD4^(+)and CD8^(+))]were compared between the two groups.Result:The nodule clearance rate and total satisfaction of the observation group were higher than those of the control group,the incidence of complications of the observation group was lower than that of the control group,the operation time and hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss of the observation group was less than that of the control group,and the aesthetic score of the observation group was higher than that of the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in serum IL-1β,TNF-α,CD3^(+),CD4^(+),CD8^(+)between the two groups(P>0.05).At 3 and 5 d after operation,the serum levels of IL-1β,TNF-αand CD8^(+)of the observation group were lower than those of the control group,and the levels of CD3^(+)and CD4^(+)of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).Before operation,there was no significant difference in the score of local discomfort between the two groups(P>0.05).At 12,24 and 48 h after operation,the scores of local discomfort of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The effect of microwave ablation in the treatment of patients with thyroid nodule is better,and it can effectively control the traumatic stress state,so its application value in the patients with thyroid nodule is relatively higher.