小切口腔镜辅助甲状腺切除术治疗PTMC患者的效果及其对甲状旁腺功能及免疫功能的影响

The effect of stomatoscope⁃assisted thyroidectomy in the treatment of patients with PTMC and its influence on parathyroid function and immune function

目的探讨小切口腔镜辅助甲状腺切除术治疗甲状腺微小乳头状癌(PTMC)患者的效果及其对甲状旁腺功能及免疫功能的影响。方法按照随机数字表法将我院2018年8月至2020年12月期间收治的97例患者PTMC分为两组,两组患者均接受手术治疗,对照组48例给予开放手术治疗,观察组49例给予小切口腔镜辅助甲状腺切除术治疗。观察两组患者手术指标、甲状旁腺功能指标、免疫功能以及并发症发生率。结果观察组手术时间、拔管时间短于对照组,切口长度小于对照组,术中出血量和术后引流量少于对照组(P<0.05);观察组血清PTH、血钙浓度高于对照组(P<0.05);观察组IgM、IgG、IgA均高于对照组(P<0.05);观察组术后继发出血、喉返神经麻痹、低钙抽搐、切口粘连、吞咽不适发生率(10.20%)低于对照组(27.06%)(P<0.05)。结论小切口腔镜辅助甲状腺切除术治疗PTMC患者可改善手术情况,调节甲状旁腺功能,减轻对免疫功能的影响,且并发症发生率更低。

Objective To investigate the effect of microincision oral endoscopic thyroidectomy in patients with minimal papillary thyroid carcinoma(PTMC)and its effect on parathyroid function and immune function.Methods According to the random number table method,97 patients with PTMC admitted to our hospital from August 2018 to December 2020 were di⁃vided into two groups.Patients in both groups received surgical treatment,48 patients in the control group received open sur⁃gery,and 49 patients in the observation group received endoscopic thyroidectomy.Operation indexes,parathyroid function in⁃dexes,immune function and complication rate of 2 groups were observed.Results The operation time and extubation time of the observation group were shorter than that of the control group,the incision length was shorter than that of the control group,and the intraoperative blood loss and postoperative drainage volume were less than that of the control group(P<0.05).The concentrations of serum PTH and serum calcium in observation group were higher than those in control group(P<0.05).IgM,IgG and IgA in observation group were higher than those in control group(P<0.05).The incidence of postoperative hemorrhage,recurrent laryngeal nerve palsy,hypocalcemia convulsion,incision adhesion and swallowing dis⁃comfort in the observation group(10.20%)was lower than that in the control group(27.06%)(P<0.05).Conclusion Mini⁃incision and endoscopic thyroidectomy for PTMC patients can improve the surgical situation,regulate parathyroid function,reduce the impact on immune function,and lower the incidence of complications.