摘要
目的探讨全腔镜甲状腺全切术治疗早期分化型甲状腺癌患者的临床疗效及对应激反应和认知功能的影响。方法依据手术方式的不同将125例早期分化型甲状腺癌患者分为对照组(n=62)和观察组(n=63),对照组患者给予开放性甲状腺切除术,观察组患者给予全腔镜甲状腺全切术。比较两组患者的临床疗效、应激反应指标[血清皮质醇、去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、超氧化物歧化酶(SOD)]、认知功能[简易精神状态量表(MMSE)]和并发症发生情况。结果观察组患者的治疗总有效率为95.24%,高于对照组患者的82.26%,差异有统计学意义(P﹤0.05)。术后,两组患者血清皮质醇、NE、AngⅡ水平均低于本组术前,SOD水平均高于本组术前,观察组患者血清皮质醇、NE、AngⅡ水平均低于对照组,SOD水平高于对照组,差异均有统计学意义(P﹤0.05)。术后2天,对照组患者MMSE评分低于本组术前和观察组,差异均有统计学意义(P﹤0.05)。观察组患者的并发症总发生率为3.17%,与对照组患者的11.29%比较,差异无统计学意义(P﹥0.05)。结论与开放性甲状腺切除术比较,全腔镜甲状腺全切术能减轻机体应激反应和认知功能障碍,提高临床疗效,且安全性较高。
Objective To investigate the clinical efficacy of total laparoscopic thyroidectomy in patients with early differentiated thyroid cancer and its effect on stress response and cognitive function.Method A total of 125 patients with early differentiated thyroid cancer were divided into control group(n=62)and observation group(n=63)according to different surgical methods.Patients in the control group were given open thyroidectomy,and patients in the observation group were given total laparoscopic thyroidectomy.The clinical efficacy,stress response indicators[serum cortisol,norepinephrine(NE),angiotensin II(Ang II),superoxide dismutase(SOD)],cognitive function[mini-mental state examination(MMSE)],and the occurrence of complications were compared between the two groups.Result The total effective rate of the observation group was 95.24%,which was higher than 82.26%of the control group,and the difference was statistically significant(P<0.05).After the surgery,the serum levels of cortisol,NE,and Ang II in the two groups were lower than those before the surgery,and the levels of SOD were higher than those before the surgery,the serum levels of cortisol,NE,and Ang II in the observation group were lower than those in the control group,and the level of SOD was higher than that in the control group,and the differences were statistically significant(P<0.05).Two days after the surgery,the score of MMSE of the control group was significantly lower than those of preoperative and the observation group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 3.17%,which was not statistically significant compared to 11.29%in the control group(P>0.05).Conclusion Compared with open thyroidectomy,total laparoscopic thyroidectomy can reduce the stress response and cognitive dysfunction,improve clinical efficacy,and have higher safety.
作者
李梦斐
张浩萌
吕勇刚
郑奔
王晓峰
杨龙
LI Mengfei;ZHANG Haomeng;LYU Yonggang;ZHENG Ben;WANG Xiaofeng;YANG Long(Department of Thyroid and Breast Surgery,the Affiliated Hospital of Northwest University/Xi’an No.3 Hospital,Xi’an 710018,Shaanxi,China;Second Ward,Department of General Surgery,the Affiliated Hospital of Northwest University/Xi’an No.3 Hospital,Xi’an 710018,Shaanxi,China)
出处
《癌症进展》
2023年第20期2264-2267,共4页
Oncology Progress
基金
陕西省重点研发计划项目(S2020-YF-YBSF-0777)
西安市卫生健康委员会科研项目(J201902045)。
关键词
全腔镜甲状腺全切术
早期分化型甲状腺癌
临床疗效
应激反应
认知功能
total laparoscopic thyroidectomy
early differentiated thyroid cancer
clinical efficacy
stress response
cognitive function