摘要
目的探讨经颏下口腔前庭入路腔镜手术在甲状腺乳头状癌(papillary thyroid carcinoma,PTC)中应用价值。方法选取2021年6月至2023年6月临沂市人民医院普外科收治的96例PTC患者,随机数字表法分为两组,各48例。两组均行腔镜甲状腺切除术,观察组采取经颏下口腔前庭入路,对照组采取经口前庭入路。统计两组围术期指标、并发症及手术前后甲状旁腺相关指标,并于术后6个月展开随访,比较两组头颈癌生命质量测定量表(the quality of life instrument for head and neck cancer,QLICP-HN)、瘢痕美容评估与评级(scar cosmesis assessment and rating,SCAR)评分。结果观察组手术时间、住院时间、术后正常进食时间、术后24 h视觉模拟评分法(visual analogue scale,VAS)评分分别为(144.41±13.38)min、(4.42±0.85)d、(2.10±0.76)d、(3.40±0.42)分,对照组为(168.18±20.24)min、(6.11±1.04)d、(2.68±0.81)d、(4.61±0.45)分,观察组手术时间、住院时间、术后正常进食时间短于对照组,术后24 hVAS评分低于对照组(P均<0.001)。术后3 d,两组甲状旁腺激素(parathyroid hormone,PTH)、血钙低于术前(P均<0.001)。观察组并发症发生率为2.08%(1/48),对照组为10.42%(5/48),两组并发症发生率比较差异无统计学意义(P=0.206)。术后3个月观察组SCAR评分为(2.60±0.34)分,明显高于对照组的(2.31±0.40)分(P<0.001);术后6个月两组SCAR评分比较差异无统计学意义(P=0.118);术后6个月两组QLICP-HN各维度评分均高于术前(P均<0.001)。结论经颏下口腔前庭入路腔镜甲状腺切除术用于PTC患者,可缩短手术时间及住院时间,缓解疼痛,改善生命质量。
ObjectiveTo explore the application value of endoscopic surgery through the submental oral vestibule approach in the treatment of papillary thyroid carcinoma(PTC).MethodsA total of 96 patients with PTC admitted to the General Surgery Department of Linyi People’s Hospital from Jun.2021 to Jun.2023 were selected and randomly divided into two groups using a random number table method,with 48 cases in each group.Both groups underwent endoscopic thyroidectomy,with the observation group undergoing a submental oral vestibular approach and the control group undergoing a transoral vestibular approach.The perioperative indexes,complications and parathyroid-related indexes before and after surgery were counted in the two groups,and follow-up was carried out at 6 months after surgery to compare the quality of life instrument for head and neck cancer(QLICP-HN),Scar cosmesis assessment and rating(SCAR)scores.ResultsThe observation group's operation time,hospitalization time,normal eating time after surgery,and postoperative 24-hour visual analogue scale(VAS)score were(144.41±13.38)min,(4.42±0.85)d,(2.10±0.76)d,and(3.40±0.42)scores,respectively,while the control group's were(168.18±20.24)min,(6.11±1.04)d,(2.68±0.81)d,and(4.61±0.45)scores.The observation group's operation time,hospitalization time,and normal eating time after surgery were shorter than those of the control group,and the postoperative 24-hour VAS score was lower than that of the control group(all P<0.001).Three days after surgery,the parathyroid hormone(PTH)and blood calcium levels in both groups were lower than those before surgery(all P<0.001).The complication rate in the observation group was 2.08%(1/48),while that in the control group was 10.42%(5/48),and there was no significant difference in the complication rate between the two groups(P=0.206).The SCAR score in the observation group was(2.60±0.34)scores,which was significantly higher than that in the control group(2.31±0.40)scores(P<0.001)three months after surgery.There was no significant difference in SCAR scores between the two groups six months after surgery(P=0.118).The QLICP-HN scores in both groups were higher than those before surgery six months after surgery(all P<0.001).ConclusionEndoscopic thyroidectomy through the submental oral vestibular approach for patients with PTC can shorten the operation time and hospitalization time,alleviate pain,and improve quality of life.
作者
张超
王瑞
刘敬华
Zhang Chao;Wang Rui;Liu Jinghua(Department of General Surgery,Linyi People’s Hospital,Linyi 276000,China)
出处
《中华内分泌外科杂志（中英文）》
CAS
2024年第6期841-845,共5页
Chinese Journal of Endocrine Surgery
基金
山东半岛国家自主创新示范区发展建设资金项目(ZCQ19206)。
关键词
甲状腺乳头状癌
腔镜甲状腺切除术
经颏下口腔前庭入路
经口前庭入路
Thyroid papillary carcinoma
Endoscopic thyroidectomy
Submental oral vestibular approach
Oral vestibular approach
作者简介
通信作者:王瑞,Email:121232658@qq.com。
