经胸前入路无注气内镜下甲状腺手术与传统手术创伤比较的随机对照研究

目的 前瞻性随机对照研究经胸前人路的无注气内镜下甲状腺手术与传统甲状腺手术对机体的创伤大小.方法 选择2006年11月至2008年2月中山大学第二附属医院耳鼻咽喉头颈外科收治的甲状腺肿物患者采用系统随机化法将患者分为两组,内镜组:25例行经胸前人路的无注气内镜甲状腺手术;传统手术组:22例行传统甲状腺手术.统计分析两组患者围手术期不同时间血中白细胞计数(white blood cell count,WBC)、C反应蛋白(serum C-reative protein,CRP)、白细胞介素6(IL-6)水平的差异.结果 在术后12,24及48 h 3个时间点,两组间WBC的差异无统计学意义(t值分别为-0.172、1.774、2.039,P＞0.05),CRP的差异无统计学意义(t值分别为-0.927、-1.701、-1.813,P＞0.05),IL-6水平的差异无统计学意义(t值分别为0.098、-2.019、-1.121,P＞0.05).结论 经胸前人路的无注气内镜甲状腺手术对机体的创伤与传统手术相比虽未达到微创的标准,但并不增加对机体的创伤.

Comparison of the surgical stress between endoscopic thyroidectomy via anterior chest approach and conventional thyroidectomy

Objective To evaluate the difference in surgical stress between gasless endoscoic thyroidectomy through anterior chest approach and conventional thyroidectomy. Methods The patients with thyroid nodules who would undergo thyroidectomy between November 2006 and February 2008 in Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Sun Yat-sen University, were randomly divided into gasless endoscopic thyroidectomy group or conventional thyroidectomy group, with 25 cases and 22 cases respectively. Before and after surgery, white blood cell count( WBC), serum C-reactive protein(CRP) and interleukin-6(IL-6) were measured to assess the surgical stress response. Results At 12 h, 24 h and 48 h after surgery, no significant difference was found between the two groups in WBC (t =- 0. 172, 1. 774 and 2. 039 respectively, P ＞ 0.05), serum CRP ( t = - 0. 927, - 1. 701 and - 1. 813,P＞0.05)and IL-6 (t =0.098, -2.019 and -1. 121, P＞0.05). Conclusion The stress response of gasless endoscopic thyroidectomy is similar with that of conventional thyroidectomy.