经胸入路腔镜甲状腺手术与传统手术治疗甲状腺结节的疗效及术后引流液成分的比较

目的:对比经胸入路腔镜甲状腺手术与传统手术治疗甲状腺结节的临床效果,比较两种手术术后引流液的性质与成分。方法:选取2018年3月至2019年9月收治的124例甲状腺结节患者,根据随机数表法将患者分为观察组与对照组,每组62例。对照组行传统甲状腺切除术,观察组行经胸入路腔镜甲状腺手术,对比两组手术指标、术后并发症及引流液成分等。结果:观察组切口长度、术中出血量、住院时间等指标优于对照组(P<0.05);观察组术后并发症总发生率为8.06%,低于对照组的29.03%,差异有统计学意义(P<0.05);观察组镇痛药使用率为6.45%(4/62),低于对照组的20.97%(13/62),差异有统计学意义(P<0.05);观察组术后总引流量少于对照组(P<0.05);术后第1天~第4天,两组引流量均逐渐减少,且观察组每天引流量小于对照组(P<0.05);术后两组引流液透明度差异有统计学意义(P<0.05),观察组引流液血清甲状旁腺激素低于对照组(P<0.05);术后第1天,观察组血清白细胞介素-6、肿瘤坏死因子水平低于对照组(P<0.05),但超敏C-反应蛋白水平差异无统计学意义(P>0.05)。结论:经胸入路腔镜甲状腺手术治疗甲状腺结节疗效确切,具有切口小、疼痛感弱、对机体损伤小等优点,可有效减少术后并发症的发生,减轻机体创伤反应。

Comparison of the curative effect and components of drainage fluid after transthoracic endoscopic minimally invasive surgery and traditional surgery for thyroid nodules

Objective:To compare the clinical effects of transthoracic endoscopic minimally invasive surgery and traditional surgery for thyroid nodules,and compare the components of drainage fluid.Methods:One hundred and twenty-four patients with thyroid nodules admitted to the hospital between Mar.2018 and Sep.2019 were selected.They were divided into the observation group and the control group by the random number table method,with 62 cases in each group.The control group was treated with traditional thyroidectomy,and the observation group was treated with transthoracic endoscopic minimally invasive surgery.The surgical indicators,postoperative complications,and components of the drainage fluid were compared between the two groups.Results:The length of incision,amount of intraoperative blood loss and length of hospital stay of the observation group were better than those of the control group(P<0.05).The total incidence of postoperative complications in the observation group(8.06%)was lower than that in the control group(29.03%,P<0.05).The use of analgesics in the observation group6.45%(4/62)]was less than that in the control group20.97%(13/62),P<0.05].The total postoperative drainage volume of the observation group was less than that of the control group(P<0.05).The drainage volume of both groups gradually decreased from the first day to fourth day after surgery,and the daily drainage volume of the observation group was less than that of the control group(P<0.05).There was significant difference in the transparency of the drainage fluid between the two groups after surgery(P<0.05).The level of serum parathyroid hormone in the drainage fluid of the observation group was lower than that in the control group(P<0.05).On the 1st day after surgery,the levels of serum interleukin-6 and tumor necrosis factor-αin the observation group were significantly lower than those in the control group(P<0.05).However,the level of high-sensitivity C-reactive protein between the two groups was not significantly different(P>0.05).Conclusions:Transthoracic endoscopic thyroid surgery is effective in the treatment of thyroid nodules.It has the advantages of small incision,mild pain and little damage to the body.It can effectively reduce the incidence of postoperative complications and body traumatic reaction.