经腋窝入路腔镜手术治疗甲状腺癌患者的疗效及对甲状腺功能的影响

Efficacy of Transaxillary Endoscopic Surgery in the Treatment of Thyroid Cancer Patients and Its Impact on Thyroid Function

目的观察经腋窝入路腔镜手术治疗甲状腺癌患者的疗效及对甲状腺功能的影响。方法选取2020年1月—2023年1月邳州市中医院收治的甲状腺癌患者80例,按随机数表法分为两组,各40例。对照组予以经颈前切开开放手术治疗,观察组予以免充气经腋窝入路腔镜手术治疗,对比两组患者的围手术期指标、切口美容满意度评分、术后疼痛评分、甲状腺功能以及并发症发生情况。结果观察组手术时间长于对照组,手术总出血量少于对照组,术后引流量多于对照组,差异有统计学意义(P<0.05)。术后24、48 h,观察组的疼痛评分均低于对照组,差异有统计学意义(P<0.05)。观察组切口满意度评分高于对照组,差异有统计学意义(P<0.05)。术后,观察组甲状旁腺激素(34.17±6.21)pg/mL、三碘甲状腺原氨酸(1.39±0.32)pmol/L、四碘甲状腺原氨酸(94.65±7.62)pmol/L均高于对照组,促甲状腺激素(0.48±0.19)mU/L低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为2.50%,低于对照组的20.00%,差异有统计学意义(χ^(2)=4.507,P<0.05)。结论甲状腺癌患者采取经腋窝入路腔镜手术治疗术后美容效果理想,术中出血量少,对患者甲状腺功能的影响相对较小,且并发症少,但手术时间较长,术后引流量多于常规开放手术,患者可根据现实情况选择治疗方案。

Objective To observe the efficacy of transaxillary endoscopic surgery in patients with thyroid cancer and its impact on thyroid function.Methods 80 cases of thyroid cancer patients admitted to Pizhou Hospital of Traditional Chinese Medicine from January 2020 to January 2023 were selected and divided into two groups of 40 cases each according to the random number table method.The control group was treated with open surgery through anterior cervical incision,and the observation group was treated with inflatable-free transaxillary endoscopic surgery.The perioperative indicators,incision cosmetic satisfaction scores,postoperative pain scores,thyroid function,and complications were compared between the two groups of patients.Results The operation time of the observation group was longer than that of the control group,the total surgical bleeding volume was less than that of the control group,and the postoperative drainage volume was more than that of the control group,and the difference was statistically significant(P<0.05).At 24 h and 48 h after surgery,the pain scores of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).The incision satisfaction score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After surgery,parathyroid hormone(34.17±6.21)pg/mL,triiodothyronine(1.39±0.32)pmol/L,and tetraiodothyronine(94.65±7.62)pmol/L in the observation group were higher than those in the control group,thyroid stimulating hormone(0.48±0.19)mU/L was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence rate of complications in the observation group was 2.50%,which was lower than 20.00%in the control group,and the difference was statistically significant(χ^(2)=4.507,P<0.05).Conclusion Laparoscopic surgery through the axillary approach for patients with thyroid cancer has satisfactory postoperative cosmetic results,less intraoperative bleeding,relatively little impact on the patient's thyroid function,and few complications.However,the operation time is longer and the amount of postoperative drain‐age is greater than that of conventional open surgery.Patients can choose treatment options based on the actual situation.