颈前微切口腔镜辅助甲状腺切除术治疗分化型甲状腺癌的效果及安全性

Effect and safety of oral endoscopic thyroidectomy through anterior cervical micro incision in the treatment of differentiated thyroid cancer

目的分析颈前微切口腔镜辅助甲状腺切除术治疗分化型甲状腺癌(DTC)的效果。方法队列研究。抽取2021年10月至2023年10月安康市人民医院收治的84例DTC患者,按照随机数字表法分成对照组和观察组,每组42例。对照组行传统甲状腺切除术,观察组行颈前微切口腔镜甲状腺切除术。比较两组围术期指标、甲状腺功能[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4),三碘甲状腺原氨酸(T3)、甲状腺素(T4)]、凝血功能、并发症。结果观察组手术时间、住院时间短于对照组,(P<0.05);观察组并发症发生率(4.76%,2/42)低于对照组(21.43%,9/42),P<0.05。术后,观察组FT3、FT4、T3、T4、纤维蛋白原水平均低于对照组,(P均<0.05);观察组凝血酶原时间[(10.47±1.46)s]、活化部分凝血活酶时间[28.99±2.38)s]均长于对照组[(9.36±1.22)、(26.31±2.15)s],差异有统计学意义(P<0.05)。结论颈前微切口腔镜甲状腺切除术创伤更小、并发症更少,能够改善DTC患者甲状腺功能,且对患者凝血功能影响较小。

ObjectiveTo analyze the effect of oral endoscopic thyroidectomy through anterior cervical micro incision on differentiated thyroid cancer(DTC).MethodsA total of 84 DTC patients admitted to Ankang People’s Hospital from October 2021 to October 2023 were divided into control group and observation group by random number table method,with 42 cases in each group.The control group underwent traditional thyroidectomy,while the observation group underwent oral endoscopic thyroidectomy through anterior cervical micro incision.The perioperative indicators,thyroid function assessed by free triiodothyronine(FT3),free thyroxine(FT4),triiodothyronine(T3)and thyroxine(T4),coagulation function,and complications of the two groups were compared.ResultsThe observation group had shorter operation duration and shorter hospital stay than the control group(P<0.05).The incidence of complications in the observation group(4.76%,2/42)was lower than that in the control group(21.43%,9/42),P<0.05.After treatment,the FT3,FT4,T3,T4 and fibrinogen in the observation group were lower than those in the control group(all P<0.05).The prothrombin time and activated partial thromboplastin time in the observation group were(10.47±1.46)s and(28.99±2.38)s,respectively,longer than the(9.36±1.22)s and(26.31±2.15)s in the control group(P<0.05).ConclusionsOral endoscopic thyroidectomy through anterior cervical micro incision has smaller trauma and fewer complications,it can improve thyroid function in DTC patients,and has less impact on coagulation function.