微波消融术与传统开放式甲状腺手术对绝经期甲状腺良性结节患者的影响

Impact of Microwave Ablation and Traditional Open Thyroid Surgery on Menopausal Patients with Benign Thyroid Nodule

目的:探究微波消融术、传统开放式甲状腺手术在绝经期甲状腺良性结节中的应用效果。方法:选取2019年1月—2022年10月九江市第三人民医院接诊的168例绝经期甲状腺良性结节患者作为研究对象,按照手术方式将其分为对照组及研究组,各84例。对照组采用传统开放式甲状腺手术治疗,研究组采用微波消融术治疗。比较两组血清中游离三碘甲状腺原氨酸(FT_(3))、血清游离甲状腺素(FT_(4))、促甲状腺激素(TSH)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平;检测CD4^(+)、CD8^(+)水平,并计算CD4^(+)/CD8^(+)比值。比较两组手术情况、治疗效果、并发症发生率及复发率。结果:研究组术中出血量、术后引流量均少于对照组,手术时间、切口长度均短于对照组(P<0.05)。术后1个月,两组FT_(3)、FT_(4)水平均低于术前,TSH水平均高于术前,且研究组FT_(3)、FT_(4)和TSH水平均高于对照组(P<0.05)。术后1 d,两组IL-6、TNF-α、CRP均高于术前,但研究组均低于对照组(P<0.05)。术后1 d,两组CD4^(+)和CD4^(+)/CD8^(+)均低于术前,CD8^(+)均高于术前,但观察组术后CD4^(+)和CD4^(+)/CD8^(+)水平均高于对照组,CD8^(+)水平低于对照组(P<0.05)。研究组治疗总有效率高于对照组,并发症发生率、复发率均低于对照组(P<0.05)。结论:应用微波消融术可有效改善绝经期甲状腺良性结节患者围手术期相关情况,且对患者甲状腺功能影响较小,并发症发生率、复发率均较低,预后情况好。

Objective:To explore the effect of microwave ablation and traditional open thyroid surgery on benign thyroid nodule in menopause.Method:A total of 168 menopausal patients with benign thyroid nodules admitted to the Third People's Hospital of Jiujiang City from January 2019 to October 2022 were selected as the study objects,and they were divided into control group and study group according to the surgical method,with 84 cases in each group.The control group was treated with traditional open thyroid surgery,and the study group was treated with microwave ablation.The levels of serum free triiodothyronine(FT_(3)),serum free thyroxine(FT_(4)),thyroid stimulating hormone(TSH),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C reactive protein(CRP)were compared between the two groups.The levels of CD4^(+)and CD8^(+)were detected,and the ratio of CD4^(+)/CD8^(+)was calculated.The surgery conditions,treatment effect,complication rate and recurrence rate were compared between the two groups.Result:The blood loss and postoperative drainage volume of the study group were lower than those of the control group,and the surgery time and incision length were shorter than those of the control group(P<0.05).One month after surgery,FT_(3),FT_(4) levels in two groups were lower than those before surgery,TSH levels were higher than those before surgery,and FT_(3),FT_(4) and TSH levels in the study group were higher than those in the control group(P<0.05).On the first day after surgery,IL-6,TNF-αand CRP in both groups were higher than those before surgery,but those in the study group were lower than those in the control group(P<0.05).On the first day after surgery,CD4^(+)and CD4^(+)/CD8^(+)in both groups were lower than those before surgery,and CD8^(+)were higher than those before surgery,but the levels of CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and the level of CD8^(+)was lower than that in the control group(P<0.05).The total effective rate of the study group was higher than that of the control group,and the complication rate and recurrence rate were lower than those of the control group(P<0.05).Conclusion:Microwave ablation can effectively improve the perioperative conditions related to menopausal patients with benign thyroid nodules,with minimal impact on thyroid function,the procedure also has a low rate of complications and recurrence,and the prognosis is favorable.