甲状腺全切除或近全切除术治疗甲状腺癌对患者甲状腺功能的影响

Effect of Total or Near-total Thyroidectomy on Thyroid Function in Patients with Thyroid Cancer

目的:探讨甲状腺全切除或近全切除术治疗甲状腺癌对患者甲状腺功能的影响。方法:选取2019年8月至2020年8月九江市第一人民医院收治的80例甲状腺癌患者为研究对象,根据手术方式进行分组,其中实施甲状腺全切除术治疗的40例患者为对照组,实施甲状腺近全切除术治疗的40例患者为观察组。比较两组患者临床治疗效果、手术情况、甲状腺功能指标、并发症发生率、复发率。结果:两组患者临床治疗总有效率比较,差异无统计学意义(P>0.05)。观察组患者术中出血量少于对照组,手术时间及住院时间短于对照组,差异具有统计学意义(P<0.05)。手术治疗后,观察组患者甲状旁腺激素、甲状腺球蛋白及血钙指标均高于对照组,差异具有统计学意义(P<0.05)。观察组患者并发症发生率低于对照组,但复发率高于对照组,差异具有统计学意义(P<0.05)。结论:在临床甲状腺癌治疗中应用甲状腺全切除或近全切除术治疗均能取得一定的治疗效果,与全切除术相比,实施近全切除术治疗损伤情况及对甲状腺功能影响较小,且术式相对安全,术后并发症发生情况较少,但远期复发概率可能更大。

Objective To investigate the effect of total or near-total thyroidectomy on thyroid function in patients with thyroid cancer.Methods A total of 80 patients with thyroid cancer admitted to Jiujiang First People's Hospital from August 2019 to August 2020 were selected as the study objects and divided into groups according to the surgical methods.Forty patients who underwent total thyroidectomy were selected as a control group and 40 patients who underwent near-total thyroidectomy were selected as an observation group.The clinical treatment efficiency,operation status,thyroid function index,complication rate and recurrence rate were compared between the two groups.Results There was no significant difference in the total effective between the two groups(P>0.05).The intraoperative blood loss in the observation group was less than that in the control group,and the operation time and hospital stay were shorter than those in the control group,with statistical significance differences(P<0.05).After operation,parathyroid hormone,thyroglobulin and blood calcium indexes in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The complication rate of the observation group was lower than that of the control group,but the recurrence rate was higher than that of the control group,the differences were statistically significant(P<0.05).Conclusion Both total and near-total thyroidectomy can achieve certain therapeutic effects in the clinical treatment of thyroid cancer.Compared with total resection,the treatment of injury and thyroid function are less affected by near-total resection,and the operation is relatively safe,with fewer postoperative complications,but the probability of long-term recurrence may be greater.