甲状腺全切术与次全切术治疗分化型甲状腺癌的临床疗效及对并发症的影响

Clinical efficacy and complication of total thyroidectomy and subtotal thyroidectomy for differentiated thyroid carcinoma

目的探讨利用甲状腺全切术与次全切术治疗分化型甲状腺癌(DTC)的疗效及对患者并发症的影响。方法回顾性分析2018年1月至2020年1月于本院行手术治疗的60例DTC患者的临床资料,根据其手术方式分为A组(n=24)与B组(n=36)。A组采用甲状腺全切术,B组采用甲状腺次全切术,比较两组手术指标(手术时间、切口长度、术中出血量)、术后康复情况(镇痛治疗时间、术后康复时间)、临床疗效及并发症发生情况。结果B组手术时间、切口长度均短于A组,术中出血量少于A组,差异有统计学意义(P<0.05)。B组镇痛治疗时间、术后住院时间均短于A组,差异有统计学意义(P<0.05)。两组治疗总有效率比较差异无统计学意义。两组继发性出血、切口感染、声音嘶哑及低钙血症发生率比较差异无统计学意义。结论甲状腺次全切术较甲状腺全切术操作更简便,造成的机体损伤较小,且安全性较高,两种术式临床疗效无明显差异。

Objective To explore Clinical efficacy and complication of total thyroidectomy and subtotal thyroidectomy for differentiated thyroid carcinoma(DTC).Methods The clinical data of 60 patients with DTC who underwent surgical treatment in our hospital from January 2018 to January 2020 were retrospectively analyzed,and they were divided into group A(n=24)and group B(n=36)according to their surgical methods.Total thyroidectomy was performed in group A and subtotal thyroidectomy was performed in group B,the operation indexes(operation time,incision length,intraoperative blood loss),postoperative rehabilitation(analgesic treatment time,postoperative rehabilitation time),clinical efficacy and complications were compared between the two groups.Results The operation time and incision length of group B were shorter than that of group A,and the intraoperative blood loss was lower than that of group A,and the difference was statistically significant(P<0.05).The time of analgesic treatment and postoperative hospitalization in group B were shorter than those in group A,and the difference was statistically significant(P<0.05).There was no significant difference in the total effective rate between the two groups.There was no significant difference in the incidence of secondary bleeding,incision infection,hoarseness and hypocalcemia between the two groups.Conclusion Compared with total thyroidectomy,subtotal thyroidectomy is easier to operate,causes less damage to the body,and has higher safety,there is no significant difference in clinical efficacy between the two methods.