摘要
【目的】探讨经胸乳入路与经腋窝入路无充气腔镜甲状腺切除术对单侧甲状腺癌患者的炎症因子、内分泌指标与应激相关指标的影响。【方法】选取2022年1月至2025年1月本院收治的110例单侧甲状腺癌患者,根据手术方式不同将患者分为对照组(经胸乳入路腔镜甲状腺切除术)和观察组(经腋窝入路无充气腔镜甲状腺切除术)。比较两组手术指标(手术时间、术中出血量、淋巴结清扫数量、术后引流量)、实验室指标[白细胞(WBC)计数、C反应蛋白(CRP)、白细胞介素-6(IL-6)、血钙、甲状旁腺素(PTH)、皮质醇(Cor)、肾上腺素(Adr)]及并发症发生情况(感染、皮下积液、暂时性声嘶、颈部不适)。【结果】观察组术中出血量、术后引流量低于对照组,差异有统计学意义(P<0.05)。术后1 d,两组患者WBC计数、CRP、IL-6水平高于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。术后3 d,两组血钙、PTH、Cor、Adr水平比较,差异无统计学意义(P>0.05)。观察组并发症总发生率为3.64%(2/55),低于对照组的14.55%(8/55),差异有统计学意义(χ2=3.96,P<0.05)。【结论】经腋窝入路无充气腔镜甲状腺切除术在减少术中出血量、减轻炎症反应方面效果较好,且不增加内分泌异常及应激反应发生风险,并发症总发生率低,安全性较好。
【Objective】To compare the effects of trans-thoracic-breast approach endoscopic thyroidectomy versus non-inflating trans-axillary approach endoscopic thyroidectomy on inflammatory factors,endocrine parameters,and stress-related indicators in patients with unilateral thyroid cancer.【Methods】A total of 110 patients with unilateral thyroid carcinoma admitted to our hospital from January 2022 to January 2025 were selected.According to the surgical approach,they were divided into the control group(55 cases,endoscopic surgery via thoracic-breast approach)and the observation group(55 cases,non-inflating trans-axillary endoscopic surgery).The two groups were compared in terms of surgical indicators(operation time,intraoperative blood loss,number of lymph nodes dissected,postoperative drainage volume),white blood cell(WBC)count,C-reactive protein(CRP),interleukin-6(IL-6),serum calcium,parathyroid hormone(PTH),cortisol(Cor),adrenaline(Adr),and complications(infection,subcutaneous effusion,transient hoarseness,neck discomfort).【Results】Intraoperative blood loss and postoperative drainage volume were lower in the observation group than in the control group(P<0.05).On postoperative day 1,levels of WBC count,CRP,and IL-6 in both groups were higher than their preoperative levels;furthermore,these levels were lower in the observation group than in the control group.The difference were statistically significant(P<0.05).Three days after surgery,there were no significant differences between the two groups in terms of serum calcium,PTH,Cor,and Adr levels(P>0.05).The complication rate in the observation group was 3.64%(2/55),which was lower than the 14.55%(8/55)in the control group(P<0.05).【Conclusion】Non-inflating trans-axillary endoscopic radical surgery for thyroid carcinoma is more effective in reducing intraoperative blood loss,alleviating inflammatory response and decreasing complications without increasing risks of endocrine and stress responses.
作者
李亚芸
华胜和
王信成
王梦龙
LI Yayun;HUA Shenghe;WANG Xincheng;WANG Menglong(Department of General Surgery,Shuyang Hospital of Traditional Chinese Medicine,Shuyang Jiangsu 223600)
出处
《医学临床研究》
2026年第3期418-421,共4页
Journal of Clinical Research
