完全腔镜甲状腺癌根治术联合纳米炭与传统开放性甲状腺癌根治术的临床应用效果对比

Comparison of clinical application effects of complete endoscopic thyroidectomy combined with nano-carbon and traditional open surgery for thyroid cancer

目的比较完全腔镜甲状腺癌根治术联合纳米炭与传统开放性甲状腺癌根治术的临床应用效果。方法112例甲状腺癌患者,按照手术治疗方案不同分成对照组和研究组,每组56例。对照组患者应用传统开放性甲状腺癌根治术治疗,研究组应用完全腔镜甲状腺癌根治术联合纳米炭治疗。比较两组临床手术情况、免疫功能、炎性指标、术后并发症发生率。结果研究组手术时间(138.29±10.38)min、住院时间(6.21±1.14)d短于对照组的(145.98±15.48)min、(8.79±1.26)d,术中出血量(47.23±9.82)ml少于对照组的(70.29±13.83)ml,淋巴结清扫个数(6.23±1.14)个多于对照组的(4.58±1.49)个(P<0.05)。手术后,研究组C反应蛋白(CRP)(3.42±2.09)mg/L、白细胞介素-6(IL-6)(2.55±0.73)ng/ml、白细胞计数(WBC)(9.31±0.26)×10^(9)/L均低于对照组的(4.69±2.31)mg/L、(3.17±0.89)ng/ml、(9.96±0.48)×10^(9)/L(P<0.05)。手术后,研究组CD8^(+)(31.32±2.31)%低于对照组的(36.64±3.25)%,CD4^(+)(45.63±6.16)%、CD4^(+)/CD8^(+)(1.37±0.34)高于对照组的(38.85±5.19)%、(1.03±0.27)(P<0.05)。研究组术后并发症发生率3.57%低于对照组的17.86%(P<0.05)。结论相比传统开放性甲状腺癌根治术,完全腔镜甲状腺癌根治术联合纳米炭可显著增加检获清扫淋巴结的数量,同时手术出血量少,缩短住院时间,术后炎性反应显著降低,利于术后恢复。

Objective To compare the clinical application effects of complete endoscopic thyroidectomy combined with nano-carbon and traditional open surgery for thyroid cancer.Methods 112 patients with thyroid cancer were divided into a control group and a study group according to different surgical regimens,with 56 cases in each group.The control group was treated with traditional open surgery for thyroid cancer,while the study group was treated with complete endoscopic thyroidectomy combined with nano-carbon.The clinical surgical situation,immune function,inflammatory index and incidence of postoperative complications were compared between the two groups.Results The study group had surgical time of(138.29±10.38)min and hospital stay of(6.21±1.14)d,which were shorter than(145.98±15.48)min and(8.79±1.26)d of the control group;the intraoperative bleeding volume was(47.23±9.82)ml in the study group,which was less than(70.29±13.83)ml in the control group;the number of lymph node dissection was(6.23±1.14)nodes in the study group,which was higher than(4.58±1.49)nodes in the control group(P<0.05).After surgery,the study group had C-reactive protein(CRP)of(3.42±2.09)mg/L,interleukin-6(IL-6)of(2.55±0.73)ng/ml,and white blood cell count(WBC)of(9.31±0.26)×10^(9)/L,which were lower than(4.69±2.31)mg/L,(3.17±0.89)ng/ml,and(9.96±0.48)×10^(9)/L in the control group(P<0.05).+After surgery,CD8 was(31.32±2.31)%in the study group,which was lower than(36.64±3.25)%in the control+group;the study group had CD4 of(45.63±6.16)%and CD4^(+)/CD8^(+)of(1.37±0.34),which were higher than(38.85±5.19)%and(1.03±0.27)in the control group(P<0.05).The incidence of postoperative complications in the study group was 3.57%,which was lower than 17.86%in the control group(P<0.05).Conclusion Compared with traditional open surgery for thyroid cancer,complete endoscopic thyroidectomy combined with nano-carbon can significantly increase the number of detected lymph nodes,reduce surgical bleeding,shorten hospital stay,and significantly reduce postoperative inflammatory response,which is conducive to postoperative recovery.