不同甲状腺手术方式对机体应激的影响

目的探讨胸乳入路、腋窝入路腔镜甲状腺手术以及常规开放甲状腺手术对机体应激创伤的影响。方法选取行甲状腺手术的病人90例，根据自愿选择手术方式分为胸乳组28例、腋窝组32例和常规组30例。比较3组病人术前、术后1、3 d的白细胞(WBC)、血糖(Glu)、C反应蛋白(CRP)和促肾上腺皮质激素(ACTH)水平。结果3组术前WBC、CRP、Glu、ACTH水平及术后3 d Glu水平差异均无统计学意义(P>0.05)；3组术后1、3 d WBC、CRP、Glu、ACTH水平均高于术前(P < 0.05)；3组术后1 d WBC、CRP、Glu、ACTH水平均高于术后3 d(P < 0.05)；术后1、3 d，常规组、腋窝组、胸乳组WBC、CRP、ACTH水平逐渐降低(P < 0.01)。结论腔镜甲状腺手术对机体应激的影响低于开放甲状腺手术。

Effects of different thyroid surgery methods on body stress

ObjectiveTo investigate the effects of endoscopic thyroid surgery via thoraco mammary approach approach, axillary approach and conventional open thyroid surgery on stress trauma.MethodsNinety patients undergoing thyroid surgery were divided into in the thoraco mammary group(n=28), axillary group(n=32) and conventional group(n=30).The levels of white blood cell(WBC), blood glucose(Glu), C reactive protein(CRP) and adreno-cortico-tropic-hormone(ACTH) in the three groups were compared before operation, 1 day and 3 days after operation.ResultsThere was no significant difference in the levels of WBC, CRP, Glu, ACTH before operation, and Glu at 3 days after operation among the three groups(P>0.05).The levels of WBC, CRP, Glu and ACTH in the three groups at 1 day and 3 days after operation were higher than those before operation(P < 0.05).The levels of WBC, CRP, Glu and ACTH in the three groups at 1 day after operation were higher than those at 3 days after operation(P < 0.05).At 1 day and 3 days after operation, the levels of WBC, CRP and ACTH gradually decreased in the conventional group, axillary group and thoraco mammary group(P < 0.01).ConclusionsThe endoscopic thyroid surgery has lower effects on stress than open thyroid surgery.