经腋窝入路免充气腔镜下行甲状腺癌根治术的临床分析

Clinical Analysis of Air-free Endoscopic Radical Thyroidectomy Transaxillary Approach

目的:研究甲状腺癌患者行经腋窝入路免充气腔镜根治术治疗的效果。方法:数据取自赣南医学院第一附属医院2019年1月-2021年12月收治的64例甲状腺癌患者,采用随机数字表法分为开放组(开放甲状腺癌根治术,n=32)、入路组(经腋窝入路免充气腔镜根治术,n=32),比较分析两组生活质量、临床指标、治疗效果、美容满意度及并发症。结果:与开放组比较,入路组手术时间、住院时间均更长(P<0.05),术中出血量、术后引流液量均更多(P<0.05),入路组术后VAS评分更低(P<0.05)。术前两组QLQ-C30各维度评分比较,差异均无统计学意义(P>0.05),术后入路组QLQ-C30各维度评分均更高(P<0.05)。入路组总有效率(96.88%)、美容总满意率(93.75%)高于开放组(81.25%、75.00%),差异均有统计学意义(χ~2=4.010、4.267,P=0.045、0.039)。术后两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:经腋窝入路免充气腔镜根治术治疗甲状腺癌可减轻术后疼痛,增强疗效,提高生活质量,获得美容满意度,可促进疾病恢复,值得推崇。

Objective:To study the effect of air-free laparoscopic radical resection through axillary approach in patients with thyroid cancer.Method:The data were collected from 64 patients with thyroid cancer who were admitted to the First Affiliated Hospital of Gannan Medical College from January 2019 to December 2021.They were divided into an open group(open radical thyroidectomy,n=32)and an approach group(by air-free laparoscopic radical resection of the axillary approach,n=32)by random number table method,the quality of life,clinical indicators,treatment effect,cosmetic satisfaction and complications were compared between the two groups.Result:Compared with the open group,the time of operetion and time of hospital stays in the approach group were longer(P<0.05),the amount of intraoperative blood loss and post-drainage fluid after operation in the approach group were more(P<0.05),and the VAS score after operation in the approach group was lower(P<0.05).There were no differences in QLQ-C30 scores in all dimensions between the two groups before operation(P>0.05),the QLQ-C30 scores in all dimensions after operation in the approach group were higher(P<0.05).The total effective rate(96.88%)and cosmetic satisfaction rate(93.75%)in the approach group were higher than those(81.25%,75.00%)in the open group(χ~2=4.010,4.267,P=0.045,0.039).There was no difference in the complication rate between the two groups after operation(P>0.05).Conclusion:The air-free laparoscopic radical resection of thyroid cancer through axillary approach can reduce postoperative pain,enhance curative effect,improve quality of life,obtain cosmetic satisfaction,and promote disease recovery,which is worthy of praise.