摘要
目的探讨经腋窝入路免充气全腔镜甲状腺癌根治术(endoscopic radical thyroidectomy,ERT)治疗颈淋巴结阴性(cervical lymph node negati v e,cN0)期甲状腺微小乳头状癌(thyroid papillary microcarcinoma,PTMC)的效果。方法选取2023年1—9月晋江市医院/上海市第六人民医院福建医院收治的82例cN0期PTMC患者,以随机数字表法分组。对照组41例采取传统开放式手术治疗,观察组41例采取经腋窝入路免充气ERT。比较2组手术指标、甲状腺激素水平[促甲状腺激素(thyroid stimulating hormone,TSH)、三碘甲状腺原氨酸(triiodothyronine,T_(3))、甲状腺激素(thyroid hormone,T_(4))]、术后各时段视觉模拟评分法(visual analogue scale,VAS)评分、术后并发症发生率、切口美学评分满意度差异。结果观察组手术时间与住院时间短于对照组,术中出血量、引流液总量低于对照组(P<0.05);2组淋巴结清扫数目比较,差异无统计学意义(P>0.05);术前,2组TSH、T_(3)、T_(4)比较,差异无统计学意义(P>0.05);术后,2组TSH、T_(3)、T_(4)优于术前,且观察组TSH、T_(3)、T_(4)优于对照组(P<0.05);观察组术后12、24、48、72 h VAS评分低于对照组(P<0.05);观察组患者术后并发症总发生率为4.88%,低于对照组的19.51%(P<0.05);观察组患者手术切口美学评分的总满意度为97.56%,高于对照组的80.49%(P<0.05)。结论经腋窝入路免充气ERT治疗cN0期PTMC的效果满意,有助于改善甲状腺功能,减少术后并发症,获得较高的美学满意度。
Objective To explore the effect of transaxillary approach non-inflatable total cavity endoscopic radical thyroidectomy(ERT)for cervical lymph node negative(cN0)stage thyroid papillary microcarcinoma(PTMC).Methods A total of 82 patients with cN0 stage PTMC treated in Jinjiang Municipal Hospital/Fujian Campus,Shanghai Sixth People's Hospital from January to September 2023 were selected and randomly divided into two groups using a number table method.The control group(n=41)received traditional open surgery,while the observation group(n=41)received transaxillary approach non-inflatable total cavity ERT.The differences of surgical indicators,thyroid hormone level[thyroid stimulating hormone(TSH),triiodothyronine(T_(3)),thyroid hormone(T_(4))],visual analogue scale(VAS)score,postoperative complication rate and incision aesthetic score satisfaction were compared between the two groups.Results The operation time and hospital stay in the observation group were shorter than those in the control group,and the amount of intraoperative blood loss and total drainage fluid were lower than those in the control group(P<0.05).There was no significant difference in the number of lymph node dissection between the two groups(P>0.05).Before operation,there was no significant difference in TSH,T_(3)and T_(4)between two groups(P>0.05).After operation,TSH,T_(3)and T_(4)in two groups were better than those before operation,and TSH,T_(3)and T_(4)in observation group were better than those in control group(P<0.05).VAS scores of observation group at 12,24,48 and 72 h after operation were lower than those of control group(P<0.05).The total incidence of postoperative complications in the observation group was 4.88%,which was lower than 19.51%in the control group(P<0.05).The total satisfaction rate of surgical incision aesthetics score in the observation group was 97.56%,which was higher than 80.49%in the control group(P<0.05).Conclusion The treatment of cN0 stage PTMC with transaxillary approach noninflatable total cavity ERT is satisfactory,helps to improve thyroid function,reduce postoperative complications and obtain higher aesthetic satisfaction.
作者
杨长安
杨波
王卿伟
叶泽毅
YANG Chang'an;YANG Bo;WANG Qingwei;YE Zeyi(Department of Thyroid and Breast Surgery,Jinjiang Municipal Hospital/Fujian Campus,Shanghai Sixth People's Hospital,Jinjiang Fujian 362200,China)
出处
《中国卫生标准管理》
2024年第16期97-101,共5页
China Health Standard Management
关键词
经腋窝入路
免充气
全腔镜甲状腺癌根治术
甲状腺微小乳头状癌
美学效果
甲状腺功能
transaxillary approach
non-inflation
total cavity endoscopic radical thyroidectomy
thyroid papillary microcarcinoma
aesthetic effect
thyroid function
