基于应激性喉返损伤探讨全切术治疗甲状腺癌的效果

Effect of total resection for thyroid cancer based on stress recurrent laryngeal injury

目的探讨基于应激性喉返损伤探讨全切术治疗甲状腺癌的效果。方法选择2019年6月—2022年12月甲状腺癌患者120例为对象,随机数字表法分为两组各60例。对照组采用全腔镜甲状腺切除手术治疗,观察组采用基于应激性喉返损伤的全腔镜甲状腺切除手术治疗(即围术期采用喉返神经保护技术),两组术后2周评估患者效果,比较两组手术指标、甲状旁腺功能及术后并发症。结果观察组手术时间长于对照组;术后镇痛及住院时间、切口长度及术中出血量低于对照组(P<0.05);两组术后2周甲状腺功能得到改善;观察组FT3、FT4、T3及T4水平低于对照组(P<0.05);TSH水平高于对照组(P<0.05);观察组术后喉返神经损伤、切口感染、声音嘶哑、手足抽搐及气管损伤发生率低于对照组(P<0.05)。结论基于应激性喉返损伤术中借助喉返神经保护技术,能减轻全腔镜甲状腺切除手术创伤,能改善患者甲状旁腺功能,术后并发症发生率较低,值得推广应用。

Objective To explore the effect of total resection for thyroid cancer based on stress recurrent laryngeal injury.Methods A total of 120 patients with thyroid cancer from June 2019 to December 2022 were selected and divided into two groups with 60 patients in each group by random number table method.The control group was treated with total endoscopic thyroidectomy,and the observation group was treated with total endoscopic thyroidectomy based on stress recurrent laryngeal injury(that is,perioperative laryngeal recurrent nerve protection technology).The effects of the two groups were evaluated 2 weeks after surgery,and the surgical indicators,parathyroid function and postoperative complications were compared between the two groups.Results The operation time of observation group was longer than that of control group.Postoperative analgesia,length of hospital stay,incision length and intraoperative blood loss were lower than those in control group(P<0.05).Thyroid function was improved 2 weeks after operation in both groups.The levels of FT_(3),FT_(4),T_(3)and T_(4) in observation group were lower than those in control group(P<0.05).TSH level was higher than that of control group(P<0.05).The incidence of recurrent laryngeal nerve injury,incision infection,hoarseness,hand and foot twitching and tracheal injury in the observation group was lower than that in the control group(P<0.05).Conclusion With the help of recurrent laryngeal nerve protection technology during the operation of traumatic recurrent laryngeal injury,it can reduce the trauma of total endoscopic thyroidectomy,improve the parathyroid function of patients,and reduce the incidence of postoperative complications,which is worthy of popularization and application.