甲状腺标准切除与全切术治疗甲状腺癌的临床疗效观察

Clinical Efficacy of Standard versus Total Thyroidectomy in the Treatment of Thyroid Cancer

目的分析甲状腺癌患者行甲状腺全切术及甲状腺标准切除术的临床治疗效果。方法纳入2020年7月至2022年6月于福鼎市医院普外科行手术治疗的甲状腺癌患者70例为研究对象,以行甲状腺全切术者为对照组(n=35),以行甲状腺标准切除术者为研究组(n=35)。比较两组的临床手术治疗指标;术后血清甲状旁腺激素(parathyroid hormone,PTH)、钙、甲状腺激素水平;术后视觉模拟评分(Visual Analogue Scale,VAS)、反流症状指数(reflux symptom index,RSI)和嗓音障碍指数(voice handicap index,VHI);手术并发症发生率。结果相较于对照组,研究组手术切口长度短、手术时间短、术中失血量小、术后引流时间短、引流量小、住院时间短;术后7 d的血PTH、钙水平高;术后3、7 d的VAS评分,以及术后7 d的RSI、VHI评分低;手术并发症发生率低,组间比较差异均具有统计学意义(均P<0.05)。两组术后7 d甲状腺激素水平比较,组间差异无统计学意义(P>0.05)。结论甲状腺标准切除术治疗可有效减少术中甲状腺组织损伤,维护术后甲状腺功能稳定,降低手术并发症风险。

Objective To analyze the clinical therapeutic effects of total thyroidectomy and standard thyroidectomy in patients with thyroid cancer.Methods Seventy thyroid cancer patients who underwent surgical treatment at the General Surgery Department of Fuding City Hospital from July 2020 to June 2022 were included in the study,with those who underwent total thyroidectomy as the control group(n=35),and those who underwent standard thyroidectomy as the study group(n=35).Comparison of clinical surgical treatment indexes;postoperative serum parathyroid hormone(PTH),calcium,and thyroid hormone levels;postoperative the Visual Analogue Scale(VAS),reflux symptom index(RSI),and voice handicap index(VHI);and incidence of surgical complications between the two groups.Results Compared with the control group,the study group had shorter surgical incision length,shorter operation time,less intraoperative blood loss,shorter postoperative drainage time,less drainage flow,and shorter hospitalization time;higher blood PTH and calcium levels at 7 d postoperatively;lower VAS scores at 3 d and 7 d postoperatively,as well as lower RSI and VHI scores at 7 d postoperatively;and lower incidence of surgical complications,with statistically significant differences between the groups(all P<0.05).Comparison of thyroid hormone levels in the two groups at 7 d postoperatively,the difference between the groups was not statistically significant(P>0.05).Conclusions Standard thyroidectomy treatment can effectively reduce intraoperative thyroid tissue damage,maintain postoperative thyroid function stability,and reduce the risk of surgical complications.