内镜辅助小切口甲状腺切除术治疗甲状腺微小乳头状癌患者的效果

Effects of endoscopic assisted small incision thyroidectomy in treatment of patients with papillary thyroid microcarcinoma

目的:探讨内镜辅助小切口甲状腺切除术治疗甲状腺微小乳头状癌(PTMC)患者的效果。方法:选取2018年6月至2022年6月该院收治的60例PTMC患者进行前瞻性研究,根据随机数字表法将其分为对照组和观察组各30例。对照组采用开放式甲状腺切除术治疗,观察组采用内镜辅助小切口甲状腺切除术治疗,比较两组围术期指标(手术时间、术中出血量、引流时间、瘢痕长度、住院时间)水平、手术前后甲状腺激素[三碘甲腺原氨酸(T_(3))、甲状腺素(T_(4))、游离三碘甲腺原氨酸(FT_(3))及游离甲状腺素(FT_(4))]水平、复发率及并发症发生率。结果:观察组手术时间长于对照组,术中出血量少于对照组,术后引流时间、住院时间、瘢痕长度均短于对照组,差异有统计学意义(P<0.05);术后3个月,两组T_(3)、T_(4)、FT_(3)、FT_(4)水平均低于术前,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05);术后随访6个月,两组均无复发情况;观察组并发症发生率为3.33%(1/30),低于对照组的26.67%(8/30),差异有统计学意义(P<0.05)。结论:与常规开放式甲状腺切除术比较,内镜辅助小切口甲状腺切除术治疗PTMC患者可减少术中出血量,缩短术后引流时间、住院时间、瘢痕长度,降低并发症发生率,但不会增高复发率,不会加重甲状腺损伤。

Objective:To investigate effects of endoscopic assisted small incision thyroidectomy in treatment of patients with papillary thyroid microcarcinoma(PTMC).Methods:A prospective study was conducted on 60 patients with PTMC admitted to the hospital from June 2018 to June 2022.According to the random number table method,these patients were divided into control group and observation group,30 cases in each group.The control group was treated with open thyroidectomy,while the observation group was treated with endoscopic assisted small incision thyroidectomy.The perioperative index levels(operation time,intraoperative blood loss,drainage time,scar length,hospitalization time),the thyroid hormones[triiodothyronine(T_(3)),thyroxine(T_(4)),free triiodothyronine(FT_(3))and free thyroxine(FT_(4))]levels before and after the operation,the recurrence rate,and the incidence of complications were compared between the two groups.Results:The operation time of the observation group was longer than that of the control group,the intraoperative blood loss was less than that of the control group,the postoperative drainage time,hospitalization time and scar length were shorter than those of the control group,and the differences were statistically significant(P<0.05).3 months after the operation,the levels of T_(3),T_(4),FT_(3) and FT_(4) in the two groups were lower than those before the operation,and the differences were statistically significant(P<0.05),but there were no significant differences between the two groups(P>0.05).After 6 months of follow-up,there was no recurrence in both groups.The incidence of complications in the observation group was 3.33%(1/30),which was lower than 26.67%(8/30)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Compared with conventional open thyroidectomy,the endoscopic assisted small incision thyroidectomy for the PTMC patients can reduce the intraoperative blood loss,shorten the postoperative drainage time,the hospitalization time,the scar length,and reduce the incidence of complications,but will not increase the recurrence rate and the thyroid injury.