完全腔镜下无充气腋窝入路单侧分化型甲状腺癌根治术的治疗效果

Therapeutic effect of unilateral radical resection of differentiated thyroid carcinoma under complete endoscopic non-pneumatic axillary approach

目的探讨完全腔镜下无充气腋窝入路单侧分化型甲状腺癌根治术的治疗效果。方法选取2019年3月至2020年3月于首都医科大学附属北京友谊医院平谷医院收治的100例进行甲状腺癌根治术的单侧分化型甲状腺癌患者,根据盲选法将患者分为对照组和观察组,各50例。对照组患者经传统的经颈前切口开放型甲状腺癌根治术,观察组患者于完全腔镜下经无充气腋窝入路行甲状腺癌根治术。比较两组患者的治疗效果,手术前后的机体应激反应[血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平。记录并比较两组患者的术后并发症发生率及复发情况。结果治疗后,观察组患者的治疗有效率高于对照组患者,差异有统计学意义(P<0.05)。术后12 h、24 h,观察组患者的IL-6、CRP和TNF-α水平均低于对照组患者,差异均有统计学意义(P<0.05)。观察组患者的总发生率低于对照组患者,差异有统计学意义(P<0.05)。术后1年内,观察组患者的复发率低于对照组患者,差异有统计学意义(P<0.05)。结论完全腔镜下经无充气腋窝入路行甲状腺癌根治术可显著提高单侧分化型甲状腺癌患者的临床疗效,改善患者的机体应激反应状态,一定程度上降低术后并发症的发生率及复发率。

Objective To investigate the therapeutic effect of unilateral radical resection of differentiated thyroid carcinoma under complete endoscopic non-pneumatic axillary approach.Method A total of 100 patients with unilateral differentiated thyroid carcinoma who underwent radical thyroidectomy in Pinggu Hospital,Beijing Friendship Hospital Affiliated to Capital Medical University from March 2019 to March 2020 were selected.The patients were divided into the control group(n=50)and the observation group(n=50)according to the blind selection method.The patients in the control group underwent traditional open radical thyroidectomy via the anterior cervical incision,and the patients in the observation group underwent unilateral radical thyroidectomy for differentiated thyroid carcinoma under the complete endoscopic non-pneumatic axillary approach.The treatment effect and the body stress response[serum interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]levels before and after the surgery were compared between the two groups.The incidence rate of postoperative complications and recurrence of the two groups were recorded and compared.Result After the treatment,the effective rate of treatment the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).At 12 h and 24 h after the surgery,the levels of IL-6,CRP,and TNF-αin the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence rate of patients in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Within one year after the surgery,the recurrence rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Radical thyroidectomy through the complete endoscopic non-pneumatic axillary approach could significantly improve the clinical efficacy of patients with unilateral differentiated thyroid carcinoma.The therapy improves the body’s stress response state and reduces the incidence and recurrence rate of postoperative complications to a certain extent.