改良Miccoli手术在甲状腺乳头癌患者中的应用效果研究

Study on the Application Effectiveness of Modified Miccoli Surgery in Patients with Papillary Thyroid Cancer

目的:探讨改良Miccoli手术对甲状腺乳头状癌(PTC)患者的影响及其安全性。方法:选取2022年10月—2023年9月海南省人民医院收治的PTC患者100例为研究对象,以随机数字表法分为试验组和对照组,各50例。试验组行改良Miccoli手术,对照组行完全腔镜术。对比两组手术指标、淋巴结清扫数量、氧化应激指标水平以及术后并发症发生率。结果:试验组术中失血量、术后引流量均少于对照组,住院时间、手术操作时间均短于对照组(P<0.001)。两组淋巴结清扫数量对比,差异无统计学意义(P>0.05)。术后48 h,两组超氧化物歧化酶、谷胱甘肽过氧化物酶水平均低于术前,丙二醛水平均高于术前,且试验组均优于对照组(P<0.05)。试验组并发症总发生率低于对照组(P=0.009)。结论:改良Miccoli手术与完全腔镜术均有较好的疗效,但改良Miccoli手术能够减少出血量、术后引流量,缩短手术时间、住院时间,有效减轻机体氧化应激反应,提高治疗安全性。

Objective:To investigate the effect of modified Miccoli surgery on patients with papillary thyroid cancer(PTC)and its safety.Methods:One hundred cases of PTC patients admitted to Hainan Provincial People's Hospital from October 2022 to September 2023 were selected as the study subjects,and were divided into the experimental group and the control group by randomized numerical table method,each with fifty cases.Modified Miccoli surgery was performed in the experimental group,and complete lumpectomy was performed in the control group.The surgical indexes,the number of lymph node dissection,the level of oxidative stress indexes and the incidence of postoperative complications were compared between the two groups.Results:Intraoperative blood loss and postoperative drainage volume of the experimental group were less than that of the control group,and the hospitalization time and surgical operation time were shorter than that of the control group(P<0.001).The difference in the number of lymph node dissection between the two groups was not statistically significant(P>0.05).At 48 h postoperatively,the levels of superoxide dismutase and glutathione peroxidase were lower than preoperative levels and malondialdehyde levels were higher than preoperative levels in both groups,and the experimental group was better than the control group(P<0.05).The total incidence of complications in the experimental group was lower than that in the control group(P=0.009).Conclusion:Modified Miccoli surgery and complete lumpectomy both have better efficacy,but modified Miccoli surgery can reduce the amount of bleeding,postoperative drainage,shorten the operation time and hospitalization time,effectively reduce the body's oxidative stress response,and improve the safety of treatment.