常规手术与微创手术治疗甲状腺功能亢进合并甲状腺癌的效果对比及对甲状腺功能的影响

摘要/Abstract

摘要： 目的探讨常规手术与微创手术治疗甲状腺功能亢进合并甲状腺癌的效果对比及对甲状腺功能的影响。方法选取2019年1月—2022年1月龙口市人民医院收治的80例甲状腺功能亢进合并甲状腺癌患者,应用随机数表法将患者分为两组,每组40例。对照组患者采取常规甲状腺全切除术治疗,观察组患者采取射频消融术治疗。对比两组患者手术时间、术中出血量、术后引流量、住院时间、治疗费用、肿瘤复发率以及并发症发生率,对比两组患者术前与术后1 d炎症因子表达水平以及术前与术后15 d甲状腺功能情况。结果观察组患者手术时间、术中出血量、术后引流量、住院时间、并发症发生率明显低于对照组（P<0.05）;术后两组患者C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）水平均升高,观察组低于对照组（P<0.05）,两组患者白细胞介素-2（IL-2）水平均降低,观察组高于对照组（P<0.05）;术后两组患者三碘甲状腺原氨酸（TT3）、总甲状腺激素（TT4）水平均升高,且观察组高于对照组,甲状旁腺激素（PTH）水平降低,且观察组低于对照组（P<0.05）。结论常规手术与微创手术治疗甲状腺功能亢进合并甲状腺癌的复发率均比较低,但采取微创手术能够进一步降低对患者甲状腺周边组织造成的损伤,促进患者早日康复的同时,减少并发症发生率,减轻患者机体炎症反应,改善患者甲状腺功能。

关键词: 射频消融, 甲状腺全切除术, 甲状腺功能亢进, 甲状腺癌, 甲状腺功能

Abstract: Objective To compare the effects of conventional surgery and minimally invasive surgery in the treatment of hyperthyroidism with thyroid cancer and its influence on thyroid function. Methods 80 patients with hyperthyroidism and thyroid cancer admitted to Longkou People's Hospital from January 2019 to January 2022 were selected and divided into two groups with 40 patients in each group. Patients in the control group were treated with conventional total thyroidectomy, and patients in the observation group were treated with radiofrequency ablation. The operation time, intraoperative blood loss, postoperative drainage, hospital length, treatment cost, tumor recurrence rate, and complication rate were compared with the expression level of inflammatory factors before and 1 d after surgery, and the thyroid function before and 15 d after surgery. Results In the observation group, the patients' operation time, intraoperative bleeding volume, postoperative discharge, hospitalization and complication rate of the were significantly lower than the control group (P<0.05); and CRP, TNF- α levels increased, lower than the control group (P<0.05), lower IL-2 levels, higher than the control group (P<0.05); TT3 and TT4 levels increased and higher than the control group, lower PTH level, and lower than the control group (P<0.05). Conclusion The recurrence rate of hyperthyroidism combined with thyroid cancer treated by conventional surgery and minimally invasive surgery is relatively low, but minimally invasive surgery can further reduce the damage to the surrounding thyroid tissue of patients, promote the early recovery of patients, reduce the incidence of complications, reduce the inflammatory reaction of patients, and improve the thyroid function of patients.

Key words: radiofrequency ablation, total thyroidectomy, hyperthyroidism, thyroid cancer, thyroid function

中图分类号:

R653

高海. 常规手术与微创手术治疗甲状腺功能亢进合并甲状腺癌的效果对比及对甲状腺功能的影响[J]. 中华养生保健, 2023, 41(21): 187-191.

GAO Hai. Comparison of the Effects of Conventional Surgery and Minimally Invasive Surgery on Hyperthyroidism Combined with Thyroid Cancer and Its Influence on Thyroid Function[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(21): 187-191.

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