近红外自体荧光显像技术辅助腔镜甲状腺手术对甲状腺良性肿瘤的治疗效果

Effect of near-infrared autofluorescence imaging assisted endoscopic thyroidectomy on benign thyroid tumors

目的 探讨近红外自体荧光显像技术辅助腔镜甲状腺手术对甲状腺良性肿瘤的治疗效果。方法 回顾性选取2017年1月至2019年12月佳木斯市中心医院收治的90例甲状腺良性肿瘤患者作为研究对象,依照患者应用的手术方式进行分组,将采用传统开放手术的45例患者设为对照组,将45例采用近红外自体荧光显像技术辅助的腔镜甲状腺手术患者设为观察组。比较两组患者相关围手术期指标,手术前后C反应蛋白(CRP)、白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)表达水平,术后疼痛程度、美观度与满意度,术后短期并发症发生率,并对所有患者进行3年随访,比较术后甲状腺肿瘤复发情况。结果 观察组患者手术时间、术中出血量、切口大小以及住院时间分别为(72.27±12.82) min、(15.31±3.27) mL、(16.01±2.51) cm、(8.46±1.37) d,均低于对照组[(87.25±13.12) min、(23.27±5.18) mL、(77.31±12.51) cm、(9.36±2.68) d],差异均有统计学意义(P<0.05),两组患者术后引流量比较,差异无统计学意义(P>0.05)。手术后,两组患者CRP、TNF-α水平均较手术前升高,IL-2水平均较手术前降低,观察组CRP、TNF-α水平分别为(161.12±16.12)μg/mL、(13.63±2.52) mg/L,均低于对照组[(196.21±13.93)μg/mL、(15.68±3.12) mg/L],IL-2水平为(3.02±1.25)μg/L,高于对照组[(2.32±0.32)μg/L],差异均有统计学意义(P<0.05)。观察组PSAS、VAS评分分别为(12.53±3.15)、(3.27±0.77)分,均低于对照组[(19.58±3.84)、(4.17±1.31)分],满意度评分为(7.68±1.63)分,高于对照组[(5.58±1.26)分],差异均有统计学意义(P<0.05)。观察组患者术后并发症发生率为6.67%,低于对照组(22.22%),差异有统计学意义(P<0.05)。观察组患者术后1、2、3年总复发率为13.33%,低于对照组(35.55%),差异有统计学意义(P<0.05)。结论 对甲状腺良性肿瘤患者采取近红外自体荧光显像技术辅助腔镜甲状腺手术能够缩短患者手术时间、减少术中出血量,促进患者早日康复,同时能够降低患者术后机体炎症反应,降低术后短期并发症发生率,减轻术后疼痛程度,提升术后美观度与满意度,且患者远期复发率较低。

Objective To investigate the therapeutic effect of near-infrared autofluorescence imaging assisted endoscopic thyroid surgery on benign thyroid tumors.Methods Ninety patients with benign thyroid tumors admitted to Jiamusi Central Hospital from January 2017 to December 2019 were selected as the study subjects.They were grouped according to the surgical methods used by the patients.Forty-five patients with traditional open surgery were selectde as the matched group and 45 patients with endoscopic thyroid surgery assisted by near-infrared autofluorescence imaging technology were selectde as the observation group.The expression levels of operation time,intraoperative blood loss,postoperative drainage,incision size,and hospital duration,C reactive protein(CRP),interleukin-2(IL-2),pre-operative tumor NF-α(TNF-α),postoperative pain,aesthetics,and satisfaction were compared between the two groups,and follow-up for 3 years,the thyroid tumor recurrence.Results The operation time,intraoperative bleeding volume,incision size and hospital stay in the observation group were(72.27±12.82)minutes,(15.31±3.27)mL,(16.01±2.51)cm,and(8.46±1.37)days,respectively,which were lower than those of the control group[(87.25±13.12)minutes,(23.27±5.18)mL,(77.31±12.51)cm,and(9.36±2.68)days],the differences were statistically significant(P<0.05);there was no statistically significant difference in postoperative drainage volume between the two groups(P>0.05).After operation,the levels of CRP and TNF-αin both groups of patients were higher than those before operation,and the levels of IL-2 were lower than those before surgery,the levels of CRP and TNF-αin the observation group were(161.12±16.12)μg/mL,(13.63±2.52)mg/L,which were lower than those in the control group[(196.21±13.93)μg/mL,(15.68±3.12)mg/L],and the level of IL-2 was(3.02±1.25)μg/L,which was higher than that in the control group[(2.32±0.32)μg/L],the differences were statistically significant(P<0.05).The PSAS and VAS scores of the observation group were(12.53±3.15),(3.27±0.77)points,which were lower than those of the matched group[(19.58±3.84),(4.17±1.31)points],and the satisfaction score of the observation group was(7.68±1.63)points,which was higher than that of the matched group[(5.58±1.26)points],the differences were statistically significant(P<0.05).The incidence of postoperative complication in the observation group was 6.67%,which was lower than that in the matched group(22.22%),the difference was statistically significant(P<0.05).The total recurrence rate of the observation group patients at 1,2,and 3 years after surgery was 13.33%,which was lower than that of the control group(35.55%),and the difference was statistically significant(P<0.05).Conclusion Endoscopic thyroidectomy assisted by near-infrared autofluorescence imaging for patients with benign thyroid tumors can reduce the operation time and intraoperative bleeding,promote the early recovery of patients,reduce the inflammatory reaction of patients after surgery,reduce the incidence of short-term complications after surgery,reduce the degree of postoperative pain,improve postoperative beauty and satisfaction,and the long-term recurrence rate of patients is low.