探讨甲状腺腺叶切除术治疗甲状腺结节的临床意义

Clinical significance of thyroid lobectomy in the treatment of thyroid nodules

目的 分析甲状腺腺叶切除术治疗甲状腺结节的临床意义。方法 148例甲状腺结节患者,随机分为次全切手术组和腺叶切除组,每组74例。次全切手术组行甲状腺次全切除手术,腺叶切除组行甲状腺腺叶切除术。比较两组患者治疗前后的甲状腺功能[促甲状腺激素(TSH)、甲状腺过氧化物酶(TPO)]以及术后并发症(声嘶、出血、感染)发生情况、手术时间、术中出血量、手术引流总量。结果 治疗后,腺叶切除组TSH(0.52±0.14)mIU/L、TPO(62.45±12.41)IU/ml均低于次全切手术组的(0.72±0.11)mIU/L、(96.12±15.45)IU/ml,差异有统计学意义(P<0.05)。腺叶切除组术后并发症发生率2.70%低于次全切手术组的17.57%,差异具有统计学意义(P<0.05)。腺叶切除组手术时间(71.21±6.10)min短于次全切手术组的(102.34±9.21)min,术中出血量(13.21±2.10)ml、手术引流总量(39.51±2.34)ml均少于次全切手术组的(30.25±5.21)、(58.45±4.21)ml,差异具有统计学意义(P<0.05)。结论 甲状腺结节行甲状腺腺叶切除术治疗的效果确切,手术时间短,术中出血量少,对机体的创伤比较轻,可改善甲状腺功能,并发症少。

Objective To analyze the clinical significance of thyroid lobectomy in the treatment of thyroid nodules.Methods A total of 148 patients with thyroid nodules were randomly divided into subtotal resection group and lobectomy group,with 74 cases in each group.Subtotal resection group was treated with subtotal thyroidectomy,and lobectomy group was treated with thyroid lobectomy.Both groups were compared in terms of thyroid function[thyroid-stimulating hormone(TSH)and thyroid peroxidase(TPO)]before and after treatment,as well as the postoperative complications(hoarseness,bleeding,infection),operative time,intraoperative blood loss,and total drainage.Results After treatment,TSH of(0.52±0.14)mIU/L and TPO of(62.45±12.41)IU/ml in the lobectomy group were higher than those of(0.72±0.11)mIU/L and(96.12±15.45)IU/ml in the subtotal resection group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the lobectomy group(2.70%)was lower than that in the subtotal resection group(17.57%),and the difference was statistically significant(P<0.05).The operative time of(71.21±6.10)min in lobectomy group was shorter than that of(102.34±9.21)min in subtotal resection group;the intraoperative blood loss of(13.21±2.10)ml and total drainage of(39.51±2.34)ml in lobectomy group were less than those of(30.25±5.21)and(58.45±4.21)ml in subtotal resection group;the differences were statistically significant(P<0.05).Conclusion The effect of thyroid lobectomy for thyroid nodules is accurate.The operative time is short,the intraoperative blood loss is less,and the trauma to the body is relatively light.It can reduce complications and improve thyroid function.