精细化甲状腺被膜解剖技术联合环甲隙显露喉返神经法在分化型甲状腺癌治疗中的应用效果

Effect of Fine Dissection of Thyroid Capsule Combined with Exposure of Recurrent Laryngeal Nerve in Cricothyroid Space on Serum PTH and Ca_(2)^(+) in Patients with Differentiated Thyroid Carcinoma

目的探讨在精细化甲状腺被膜解剖技术联合环甲隙显露喉返神经(RLN)在分化型甲状腺癌(DCT)治疗中的应用效果。方法采用随机数字表法将2020年1月至2021年6月医院收治的80例DCT患者分为2组,各40例。观察组采用精细化甲状腺被膜解剖技术联合环甲隙显露RLN法,对照组采用常规手术联合甲状腺下动脉显露RLN法。观察至术后7 d,比较2组围术期指标、甲状旁腺激素(PTH)、血钙(Ca_(2)^(+))水平、声带功能及并发症情况。结果2组淋巴结清扫数目、出血量及手术时长比较,无统计学差异(P>0.05)。2组术后PTH、Ca_(2)^(+)水平均比术前低,但观察组比对照组高(P<0.05)。2组术后振幅微扰、基频微扰、标准化噪声能量(NNE)水平均较术前降低,且观察组低于对照组;2组谐波噪声比(HNR)水平均较术前升高,且观察组比对照组高(P<0.05)。观察组术后并发症发生率为7.50%,低于对照组32.50%(P<0.05)。结论对DCT患者采用精细化甲状腺被膜解剖技术联合环甲隙显露RLN法治疗可改善声带功能,调节血清PTH、Ca_(2)^(+)水平,降低并发症发生风险。

Objective To explore the application effect of refined thyroid capsule dissection combined with exposure of recurrent laryngeal nerve(RLN)in the treatment of differentiated thyroid cancer(DCT).Methods 80 DCT patients were divided into 2 groups using a random number table method,with 40 patients in each group.The observation group used refined thyroid capsule dissection technology combined with the exposure of RLN in the circumferential thyroid space,while the control group used routine surgery combined with the exposure of RLN in the inferior thyroid artery.Observe until 7 days after surgery and compare the perioperative indicators,parathyroid hormone(PTH),blood calcium(Ca_(2)^(+))levels,vocal cord function,and complications between the 2 groups.Results There was no statistically significant difference in the number of lymph node dissection,bleeding volume,and surgical duration between the 2 groups(P>0.05).The postoperative PTH and Ca_(2)^(+)levels in both groups were lower than before surgery,and the observation group was higher than the control group(P<0.05).The postoperative amplitude perturbation,fundamental perturbation,and normalized noise energy(NNE)levels in both groups were lower than those before surgery,and the observation group was lower than the control group;The level of harmonic noise ratio(HNR)in both groups was higher than before surgery,and the observation group was higher than the control group(P<0.05).The incidence of postoperative complications in the observation group was 7.50%lower than that in the control group,which was 32.50%(P<0.05).Conclusion The use of refined thyroid capsule dissection combined with RLN exposure in the circumferential thyroid space can improve vocal cord function,regulate serum PTH and Ca_(2)^(+)levels,and reduce the risk of complications in DCT patients.