两种不同手术方式在分化型甲状腺癌手术中应用的效果比较

Comparative Effectiveness of Two Different Surgical Approaches in the Treatment of Differentiated Thyroid Cancer

目的:探究两种不同手术方式在分化型甲状腺癌手术中的应用效果。方法:本研究开展时间为2022年3月—2023年3月,将106例在阳江市阳东区人民医院诊断为分化型甲状腺癌患者根据临床评估情况进行分组。A组行甲状腺全切术,B组行患侧甲状腺叶及峡部切除术,各53例。对两组的治疗效果进行评价,并比较组间围手术期临床指标、甲状腺功能差异,并对患者进行1年随访,记录患者术后并发症的发生情况及预后情况。结果:两组患者的治疗总有效率比较,差异无统计学意义(P>0.05)。两组术后第1天引流量、术中出血量、手术时间、住院时间比较,差异无统计学意义(P>0.05)。治疗前,两组患者的甲状腺功能指标比较,差异无统计学意义(P>0.05);治疗后,两组三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平均降低,且B组高于A组,差异有统计学意义(P<0.05)。B组的并发症总发生率低于A组,差异有统计学意义(P<0.05)。A组在随访期内局部复发、淋巴结转移、远处转移的发生率低于B组,差异有统计学意义(P<0.05)。结论:在对分化型甲状腺癌患者进行治疗时,选用甲状腺全切术可降低患者术后复发情况,而患侧甲状腺叶及峡部切除术可减少对甲状腺功能的影响,减少术后并发症的发生,临床可根据实际情况灵活选择。

Objective:To explore the effect of two different surgical approaches in the treatment of differentiated thyroid cancer.Method:This study was conducted from March 2022 to March 2023,106 patients diagnosed with differentiated thyroid cancer at Yangdong District People's Hospital of Yangjiang City were grouped according to clinical evaluation.Group A underwent total thyroidectomy,and group B underwent hemithyroidectomy with isthmusectomy,with 53 patients in each group.The treatment outcomes were evaluated,and perioperative clinical indicators,thyroid function differences were compared.A one-year follow-up was conducted to record postoperative complications and prognosis.Result:There was no significant difference in the total effective rate between the two groups(P>0.05).There were no significant differences in drainage on the first day after surgery,intraoperative blood loss,operation time and hospital stay between the two groups(P>0.05).Before treatment,there were no significant differences in thyroid function indexes between the two groups(P>0.05);after treatment,the levels of triiodothyronine(T3),thyroxine(T4),free triiodothyronine(FT3)and free thyroxine(FT4)in both groups were decreased,and those in group B were higher than those in group A,the differences were statistically significant(P<0.05).The total complication rate of group B was lower than that of group A,and the difference was statistically significant(P<0.05).During the follow-up period,the incidence of local recurrence,lymph node metastasis and distant metastasis in group A was lower than that in group B,and the difference was statistically significant(P<0.05).Conclusion:In the treatment of patients with differentiated thyroid cancer,total thyroidectomy can reduce postoperative recurrence,while hemithyroidectomy with isthmusectomy can minimize the impact on thyroid function and reduce the occurrence of postoperative complications,clinicians can choose flexibly based on the actual conditions.