ERAS理念下行淋巴结清扫术对甲状腺癌患者的影响

The Impact of Lymph Node Dissection Under ERAS Concept on Thyroid Cancer Patients

目的探讨加速康复外科(enhanced recovery after surgery,ERAS)理念下行淋巴结清扫术对甲状腺癌患者的影响。方法抽取2020年7月—2022年7月于漳州市第三医院接受诊断治疗的70例需行手术治疗的甲状腺癌患者为观察对象,将入组案例以抛币法进行随机分组,根据其正反面分为对照组和观察组。对照组(硬币抛掷为反面的35例患者)实施甲状腺腺叶切除联合同侧中央区淋巴结清扫术治疗,观察组(硬币抛掷为正面的35例患者)在ERAS理念下行甲状腺腺叶切除联合同侧中央区淋巴结清扫术治疗。对两组患者的相关治疗指标、并发症发生情况和治疗满意度进行比较。结果(1)观察组手术时间、术中出血量、术后引流量以及住院时间分别为(198.75±35.97)min、(20.93±5.46)mL、(23.38±6.11)mL、(7.27±1.36)d,均优于对照组的(227.86±47.25)min、(25.81±7.03)mL、(27.44±8.29)mL、(9.85±2.52)d,差异有统计学意义(P<0.05)。(2)观察组并发症总发生率低于对照组(11.43%vs.28.57%),差异有统计学意义(P<0.05)。(3)观察组总满意度高于对照组(94.29%vs.80.00%),差异有统计学意义(P<0.05)。结论ERAS理念下行甲状腺腺叶切除联合同侧中央区淋巴结清扫术的手术效果更好,可以帮助优化手术指标,降低术后并发症发生风险,提高患者对治疗的满意度。

Objective To explore the impact of lymph node dissection under the concept of enhanced recovery after surgery(ERAS)on thyroid cancer patients.Methods A total of 70 thyroid cancer patients who underwent surgical treatment at the Third Hospital of Zhangzhou from July 2020 to July 2022 were selected as observation subjects.The enrolled cases were randomly divided into control group and observation group based on their positive and negative sides,using the coin toss method.The control group(35 patients with coin toss as the reverse)underwent thyroid lobectomy and ipsilateral central lymph node dissection,while the observation group(35 patients with coin toss as the front)underwent thyroid lobectomy and ipsilateral central lymph node dissection under the ERAS concept.The relevant treatment indicators,incidence of complications,and treatment satisfaction of two groups of patients were compared.Results(1)Operation time,intraoperative blood loss,postoperative drainage volume and hospital stay in the observation group were(198.75±35.97)min,(20.93±5.46)mL,(23.38±6.11)mL and(7.27±1.36)d,respectively.They were better than the control group(227.86±47.25)min,(25.81±7.03)mL,(27.44±8.29)mL,(9.85±2.52)d,and the differences were statistically significant(P<0.05).(2)The total complication rate of the observation group was lower than that of the control group(11.43%vs.28.57%),and the difference was statistically significant(P<0.05).(3)The total satisfaction of observation group was higher than that of control group(94.29%vs.80.00%),and the difference was statistically significant(P<0.05).Conclusion The surgical effect of thyroid lobectomy combined with ipsilateral central lymph node dissection under the ERAS concept is better,which can help optimize surgical indicators,reduce the risk of postoperative complications,and improve patient satisfaction with treatment.