全切与近全切手术治疗甲状腺癌患者的临床疗效

Clinical Efficacy of Total Versus Near-total Resection Surgery for Patients with Thyroid Cancer

目的对全切手术与近全切手术在甲状腺癌疾病治疗中的临床效果进行探析。方法便利选取2015年7月—2020年6月菏泽市立医院收治的98例甲状腺癌患者作为研究对象,按随机数表法将其分为参照组与观察组,各49例。前者采取甲状腺全切除手术,后者采取甲状腺近全切手术。对两组患者的手术效果、手术指标(手术时间、术中出血量、住院时间)、并发症发生情况以及治疗前后甲状旁腺激素与血清钙离子水平进行观察与比较。结果观察组治疗总有效率为91.84%与参照组的87.76%相比,差异无统计学意义(χ^(2)=0.445,P>0.05)。观察组手术时间、术中出血量及住院时间均优于参照组,差异有统计学意义(P<0.05)。治疗前,两组甲状旁腺激素、血清钙离子比较,差异无统计学意义(P>0.05);治疗后,两组甲状旁腺激素、血清钙离子比治疗前下降,且观察组甲状旁腺激素、血清钙离子优于参照组,差异有统计学意义(P<0.05)。观察组术后并发症总发生率明显低于参照组,差异有统计学意义(χ^(2)=5.765,P<0.05)。观察组术后复发率与参照组相比,差异有统计学意义(χ^(2)=4.346,P<0.05)。结论在甲状腺癌治疗中,全切与近全切手术的效果相近,但近全切手术对患者甲状旁腺激素、血清钙离子影响小,且术后并发症少。

Objective To explore the clinical effect of total resection and near total resection in the treatment of thyroid cancer.Methods A total of 98 patients with thyroid cancer admitted to Heze Municipal Hospital from July 2015 to June 2020 were conveniently selected as research objects and divided into control group and observation group according to random number table method,with 49 cases in each group.Total thyroidectomy was performed in the former and nearly total thyroidectomy in the latter.The surgical effects,surgical indicators(operation time,intraoperative blood loss,length of hospital stay),complications,parathyroid hormone and serum calcium ions level before and after treatment were observed and compared between the two groups.Results The total effective rate was 91.84%in the observation group and 87.76%in the control group,and the difference was not statistically significant(χ^(2)=0.445,P>0.05).The operation time,intraoperative blood loss and hospital stay in the observation group were better than those in the reference group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in parathyroid hormone and serum calcium ions between the two groups(P>0.05).After treatment,parathyroid hormone and serum calcium ions were decreased in two groups compared with before treatment,and the parathyroid hormone and serum calcium ions in the observation group were better than those in the reference group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the reference group,and the difference was statistically significant(χ^(2)=5.765,P<0.05).The recurrence rate of the observation group was significantly different from that of the reference group(χ^(2)=4.346,P<0.05).Conclusion In the treatment of thyroid cancer,the effect of total resection is similar to that of neartotal resection,but neartotal resection has little effect on parathyroid hormone and serum calcium ion,and fewer postoperative complications.