胸乳入路腔镜甲状腺手术与传统甲状腺手术对患者围术期疼痛及吞咽功能的影响

Effects of Breast-mammary Approach Endoscopic Thyroid Surgery and Traditional Thyroid Surgery on Perioperative Pain and Swallowing Function

目的探讨胸乳入路腔镜甲状腺手术与传统甲状腺手术对患者围术期疼痛及吞咽功能的影响。方法方便选取2020年10月—2022年10月在福建省泉州医学高等专科学校附属人民医院普外科确诊的140例甲状腺乳头状腺癌(papillary thyroid carcinoma,PTC)患者为研究对象,均进行手术治疗。根据简单随机分组,对照组采用传统甲状腺手术(n=70),观察组采用经胸乳入路腔镜甲状腺手术(n=70),比较两组患者的术后疼痛评分、吞咽功能、围术期指标和不良事件发生情况。结果观察组患者术后12、24、48 h的VAS评分均低于对照组,差异有统计学意义(P<0.05)。观察组患者术后48 h的FOIS评分高于对照组,SSA评分低于对照组,差异有统计学意义(P<0.05)。观察组患者手术时间、术中失血量、术后引流量和术后住院时间围术期指标均优于对照组,差异有统计学意义(P<0.05)。两组声音嘶哑、皮下瘀斑、饮水呛咳和手足抽搐等不良事件总发生率比较,差异无统计学意义(P>0.05)。结论胸乳入路腔镜甲状腺手术治疗甲状腺乳头状腺癌患者,可降低患者疼痛程度,减轻对吞咽功能的损伤。

Objective To explore the effect of thoracic breast approach endoscopic thyroid surgery and traditional thyroid surgery on perioperative pain and swallowing function.Methods 140 patients with papillary thyroid carcinoma(PTC)diagnosed in the General Surgery Department of the People's Hospital Affiliated to Quanzhou Medical College in Fujian Province from October 2020 to October 2022 were conveniently selected as the study subjects,all of whom underwent surgical treatment.According to the simple randomized grouping,with the control group receiving traditional thyroid surgery(n=70)and the observation group receiving endoscopic thyroid surgery through the chest and breast approach(n=70).The postoperative pain scores,swallowing function,perioperative indicators,and incidence of adverse events were compared between the two groups of patients.Results The VAS scores of the observation group patients at 12,24,and 48 hours after surgery were lower than those of the control group,the difference was statistically significant(P<0.05).The FOIS score of the observation group patients at 48 hours after surgery was higher than that of the control group,and the SSA score was lower than that of the control group,the difference was statistically significant(P<0.05).The perioperative indicators such as operation time intraoperative blood loss,postoperative drainage volume,and postoperative hospital stay in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse events such as hoarseness,subcutaneous ecchymosis,coughing after drinking water,and hand and foot convulsions between the two groups(P>0.05).Conclusion Thoracic breast approach endoscopic thyroidectomy can reduce the degree of pain and reduce damage to swallowing function in patients with papillary thyroid carcinoma.