无充气腋窝入路腔镜甲状腺癌根治术治疗甲状腺乳头状癌的效果分析

Effect Analysis of Endoscopic Radical Thyroidectomy by a Gasless Unilateral Axillary Approach in Treatment of Thyroid Papillary Carcinoma

目的:探讨无充气腋窝入路腔镜甲状腺癌根治术(GUA)治疗甲状腺乳头状癌的效果。方法:选取2022年1月—2023年12月湖南省人民医院收治的72例甲状腺乳头状癌患者作为研究对象,随机分为常规组(n=36)与无充气组(n=36)。常规组实施颈前开放入路甲状腺癌根治术,无充气组实施GUA。比较两组治疗效果。结果:两组中央区淋巴结清扫数目比较,差异无统计学意义(P>0.05);无充气组手术时间长于常规组,术后引流量多于常规组,术后住院时间短于常规组(P<0.001)。无充气组并发症发生率低于常规组(P=0.041)。术后1个月,两组甲游离三碘甲腺原氨酸、游离甲状腺素、甲状旁腺激素水平低于术前1 d,但无充气组高于常规组(P<0.05);两组促甲状腺激素水平高于术前1 d,但无充气组低于常规组(P<0.05)。结论:GUA治疗甲状腺乳头状癌的效果显著,可促进患者康复,降低并发症发生率,且对甲状腺功能影响较小。

Objective:To explore the effects of endoscopic radical thyroidectomy by a gasless unilateral axillary approach(GUA)in treatment of thyroid papillary carcinoma.Methods:A total of 72 patients with thyroid papillary carcinoma admitted to the People's Hospital of Hunan Province from January 2022 to December 2023 were selected as the study subjects.They were randomly divided into a gasless group(n=36)and a conventional group(n=36).The conventional group received radical thyroidectomy by anterior cervical open approach,while the gasless group received GUA surgery.The treatment effects of the two groups were compared.Results:There was no significant difference in the number of central lymph node dissections between the two groups(P>0.05).The operation time in the gasless group was longer than that in the conventional group,the postoperative drainage volume in the gasless group was higher than that in the conventional group,and the postoperative hospitalization time in the gasless group was shorter than that in the conventional group(P<0.001).The incidence of complications in the gasless group was lower than that in the conventional group(P=0.041).At 1 month after surgery,the levels of free triiodothyronine,free thyroxine and parathyroid hormone in the two groups were lower than those on preoperative 1 d,but the levels in the gasless group were higher than those in the conventional group(P<0.05);The level of thyroid-stimulating hormone in the two groups was higher than that on preoperative 1 d,but the level in the gasless group was lower than that in the conventional group(P<0.05).Conclusion:The treatment effect of GUA on thyroid papillary carcinoma is significant,which can promote patient recovery,reduce the incidence of complications,and has a relatively small impact on thyroid function.