无充气经腋窝入路与胸乳入路腔镜在甲状腺单侧腺叶切除术中的应用效果

Application effect of non-inflated transaxillary approach versus thoracic breast approach lumpectomy in unilateral thyroid lobectomy

目的无充气经腋窝入路腔镜与分析胸乳入路在甲状腺单侧腺叶切除术中的应用效果。方法选择2020年5月至2022年5月南京中医药大学沭阳附属医院收治的98例单侧甲状腺结节患者,以随机数字表法分为对照组(49例,经胸乳入路腔镜行甲状腺单侧腺叶切除术)与观察组(49例,无充气经腋窝入路腔镜行甲状腺单侧腺叶切除术)。比较两组手术相关指标、免疫功能、美容满意度及并发症。结果两组手术时间比较,差异无统计学意义(P>0.05)。观察组术后引流量、术中出血量低于对照组,差异有统计学意义(P<0.05);观察组术后住院时间短于对照组,差异有统计学意义(P<0.05)。两组术后1 d的CD3^(+)、CD4^(+)水平低于术前,观察组高于对照组,差异有统计学意义(P<0.05);两组术后1 d的CD8+水平高于术前,观察组低于对照组,差异有统计学意义(P<0.05)。观察组美容效果满意度优于对照组,差异有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论与经胸乳入路腔镜行甲状腺单侧腺叶切除术比较,无充气经腋窝入路腔镜应用于单侧甲状腺结节患者效果更优,可减轻手术创伤、促进患者恢复、提升美容效果满意度,对患者免疫功能影响较小,且安全可靠。

Objective To analyze the application effect of non-inflated transaxillary approach lumpectomy versus thoracic breast approach in unilateral thyroid lobectomy.Methods Ninety-eight patients with unilateral thyroid nodules admitted to Shuyang Affiliated Hospital,Nanjing University of Chinese Medicine from May 2020 to May 2022 were selected and divided into control group(49 patients with unilateral thyroid lobectomy by lumpectomy through the thoracic breast approach)and observation group(49 patients with uninflatable unilateral thyroid lobectomy by lumpectomy through the axillary approach)by the random number table method.The surgery-related indicators,immune function,cosmetic satisfaction,and complications between the two groups were compared.Results There was no statistically significant difference in the operative time between the two groups(P>0.05).The postoperative drainage and intraoperative bleeding in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);the postoperative hospital stay in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The levels of CD3^(+)and CD4^(+)in the two groups one day after surgery were lower than those before surgery,while those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05);the levels of CD8+in the two groups one day after surgery were higher than those before surgery,while those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The satisfaction of the cosmetic effect in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Compared with unilateral thyroid lobectomy by trans-thoracic breast approach lumpectomy,non-inflated transaxillary approach lumpectomy is more effective in patients with unilateral thyroid nodules,which can reduce surgical trauma,promote patient recovery,enhance satisfaction with cosmetic results,and have less impact on patient immune function,and is safe and reliable.