颈前微切口腔镜甲状腺切除术对分化型甲状腺癌患者的治疗效果

Therapeutic effect of anterior cervical microsurgical oral endoscopic thyroidectomy in patients with differentiated thyroid carcinoma

目的探讨颈前微切口腔镜甲状腺切除术对分化型甲状腺癌(DTC)患者的治疗效果。方法根据手术方法的不同将148例DTC患者分为对照组(n=73,传统甲状腺切除术)和观察组(n=75,颈前微切口腔镜甲状腺切除术)。比较两组患者的手术相关指标、凝血功能指标[活化部分凝血活酶时间(APTT)、纤维蛋白原、凝血酶原时间(PT)]及并发症发生情况。结果观察组患者的疾病控制率为90.67%,明显高于对照组患者的71.23%,差异有统计学意义(P<0.01)。观察组患者的手术时间、术后住院时间均明显短于对照组,淋巴结清扫数目明显多于对照组,差异均有统计学意义(P<0.01)。术后,两组患者的纤维蛋白原水平均高于本组术前,APTT、PT均短于本组术前,观察组患者的纤维蛋白原水平低于对照组,APTT、PT均长于对照组,差异均有统计学意义(P<0.05)。观察组患者的并发症总发生率低于对照组(P<0.05)。结论与传统甲状腺切除术相比,颈前微切口腔镜甲状腺切除术对DTC患者的治疗效果较好,可缩短手术时间和术后住院时间,改善患者的凝血功能,且并发症发生率较低。

Objective To investigate the therapeutic effect of anterior cervical microsurgical oral endoscopic thyroidectomy in patients with differentiated thyroid carcinoma(DTC).Method A total of 148 DTC patients were divided into control group(n=73,traditional thyroidectomy)and observation group(n=75,anterior cervical microsurgical oral endoscopic thyroidectomy)according to different surgical methods.The surgery-related indicators,coagulation function indicators[activated partial thromboplastin time(APTT),fibrinogen,prothrombin time(PT)],and complications were compared between the two groups.Result The disease control rate in the observation group was 90.67%,higher than 71.23%in the control group,and the difference was statistically significant(P<0.01).The operation time and postoperative hospital stay in the observation group were significantly shorter than those in the control group,and the number of lymph nodes dissected was significantly more than that in the control group,and the differences were statistically significant(P<0.01).After the operation,the levels of fibrinogen in the two groups were higher than those before the operation,and APTT and PT were shorter than those before the operation,the fibrinogen level in the observation group was lower than that in the control group,APTT and PT were longer than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion Compared with traditional thyroidectomy,anterior cervical microsurgical oral endoscopic thyroidectomy has a better therapeutic effect on patients with DTC,which can shorten the operation time and postoperative hospital stay,and improve the coagulation function of patients.Meanwhile,the risk of complications is low.