全切与近全切手术治疗甲状腺癌的效果及对复发的影响

Effect of Total and Near-total Resection Surgery in the Treatment of Thyroid Carcinoma and Its Influence on Recurrence

目的:探讨甲状腺癌患者采用全切手术或近全切手术治疗的效果及对复发的影响。方法:从滨州市中心医院2021年10月—2022年10月收治的甲状腺癌患者中,抽取80例进行回顾性分析,根据不同的治疗方法将其分为两组。对照组(n=40)采用全切手术治疗,观察组(n=40)采用近全切手术治疗。对比两组的临床总有效率、围手术期指标、手术前后的甲状腺功能、并发症发生率及复发率。结果:两组临床总有效率比较,差异无统计学意义(P>0.05);观察组的术中出血量少于对照组,手术时间和住院时间均短于对照组,差异均有统计学意义(P<0.05);观察组的促甲状腺激素(TSH)低于对照组,游离三碘甲腺原氨酸(FT_(3))和游离甲状腺素(FT_(4))均高于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组术后复发率高于对照组,差异有统计学意义(P<0.05)。结论:甲状腺癌患者采用全切手术和近全切手术治疗的效果相当,其中,全切手术的术后复发率相对较低,而近全切手术能有效减少术中出血量,缩短术后康复时间,对甲状腺功能的影响较小,且能降低并发症发生率。

Objective:To investigate the effect of total and near-total resection surgery in the treatment of patients with thyroid carcinoma and its influence on recurrence.Method:A total of 80 patients with thyroid carcinoma admitted to Binzhou Central Hospital from October 2021 to October 2022 were selected for retrospective analysis,and they were divided into two groups according to different treatment methods.The control group(n=40)was treated with total resection surgery,and the observation group(n=40)was treated with near-total resection surgery.The clinical total effective rate,perioperative indexes,thyroid function before and after surgery,complication rate and recurrence rate were compared between the two groups.Result:There was no significant difference in total effective rate between the two groups(P>0.05).The intraoperative bleeding volume 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,the differences were statistically significant(P<0.05).Thyroid stimulating hormone(TSH)in observation group was lower than that in control group,free triiodothyronine(FT_(3))and free thyroxine(FT_(4))were higher than those in control group,the differences were statistically significant(P<0.05).The complication rate of observation group was lower than that of control group,the difference was statistically significant(P<0.05).The recurrence rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion:The results of total resection surgery and near-total resection surgery are similar for patients with thyroid carcinoma.Among them,the postoperative recurrence rate of total resection surgery is relatively low,while near-total resection surgery can effectively reduce intraoperative bleeding volume,shorten postoperative rehabilitation time,have less impact on thyroid function,and reduce the incidence of complications.