内镜联合低位小切口治疗甲状腺良性结节的炎症因子及免疫指标分析
|
摘要
目的观察内镜联合低位小切口手术治疗甲状腺良性结节患者的临床效果。方法选择甲状腺良性结节患者120例,按照随机数字表法分为对照组和观察组各60例,对照组实施传统开放性甲状腺手术,观察组实施内镜联合低位小切口手术,比较2组手术情况、免疫功能指标、术后并发症发生情况、术后疼痛评分、血清炎症因子指标。结果观察组手术切口长度短于对照组,术中出血量少于对照组(P<0.05),2组手术时间差异无统计学意义(P>0.05)。术后,2组CD3~+、CD4~+/CD8~+明显低于术前,观察组CD3~+、CD4~+/CD8~+高于对照组(P<0.05)。观察组术后并发症总发生率低于对照组(P<0.05)。术后各时间点疼痛评分呈降低趋势,观察组疼痛评分低于对照组,其组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05)。观察组C反应蛋白、白细胞介素6、降钙素原水平均低于对照组(P<0.05)。结论内镜联合低位小切口手术治疗甲状腺良性结节,可缩短手术切口长度,有效减少术中出血量和术后并发症发生率,有利于保护患者免疫功能,抑制炎症因子。
Objective To study the clinical effect of endoscopic combined low-incision operation in patients with benign thyroid nodules. Methods One hundred and twenty patients with benign thyroid nodules were selected and randomly divided into two groups(60 cases each). The control group was treated with open thyroid surgery. The observation group was treated with endoscopic combined low incision operation. The operation condition, immune function index, postoperative complications, postoperative pain score, serum inflammatory factor index were compared between the two groups. Results The incision length of the observation group was shorter than that of the control group, and the intraoperative blood loss was less than that of the control group(P<0.05). However, there was no statistical difference in operation time between the two groups(P>0.05). After surgery, the CD3~+ and CD4~+/CD8~+ in the two groups were lower than those before surgery, while the CD3~+ and CD4~+/CD8~+ of the observation group were higher than those of the control group(P<0.05). The total incidence of postoperative complications was lower in the observation group than in the control group(P<0.05). Postoperative pain scores showed a decreasing trend at each time point, and the observation group was lower than the control group. There were significant differences in the interaction between the groups, between the time points, and between groups and time points(P<0.05).The levels of C-reactive protein, interleukin-6 and procalcitonin in the observation group were lower than those in the control group(P<0.05). Conclusion In the treatment of benign thyroid nodule, the length of incision is shortened by endoscopy combined with low incision, which can effectively reduce the amount of intraoperative bleeding, reduce postoperative complications, protect the immune function of patients and inhibit inflammatory factors.
Objective To study the clinical effect of endoscopic combined low-incision operation in patients with benign thyroid nodules. Methods One hundred and twenty patients with benign thyroid nodules were selected and randomly divided into two groups(60 cases each). The control group was treated with open thyroid surgery. The observation group was treated with endoscopic combined low incision operation. The operation condition, immune function index, postoperative complications, postoperative pain score, serum inflammatory factor index were compared between the two groups. Results The incision length of the observation group was shorter than that of the control group, and the intraoperative blood loss was less than that of the control group(P<0.05). However, there was no statistical difference in operation time between the two groups(P>0.05). After surgery, the CD3~+ and CD4~+/CD8~+ in the two groups were lower than those before surgery, while the CD3~+ and CD4~+/CD8~+ of the observation group were higher than those of the control group(P<0.05). The total incidence of postoperative complications was lower in the observation group than in the control group(P<0.05). Postoperative pain scores showed a decreasing trend at each time point, and the observation group was lower than the control group. There were significant differences in the interaction between the groups, between the time points, and between groups and time points(P<0.05).The levels of C-reactive protein, interleukin-6 and procalcitonin in the observation group were lower than those in the control group(P<0.05). Conclusion In the treatment of benign thyroid nodule, the length of incision is shortened by endoscopy combined with low incision, which can effectively reduce the amount of intraoperative bleeding, reduce postoperative complications, protect the immune function of patients and inhibit inflammatory factors.
引文
[1] 高峰,吴迟.传统甲状腺切除术与改良小切口甲状腺切除术治疗甲状腺结节的临床疗效比较[J].标记免疫分析与临床,2016,23(5):514-516.
[2] 王隽,权红光.低位小切口切除术治疗甲状腺瘤的疗效及安全性分析[J].实用癌症杂志,2016,31(8):1314-1316.
[3] 伍盛华,余洁芳,容宽朝.手术治疗甲状腺结节370例的临床分析[J].广西医学,2014,36(7):992-994.
[4] 梁伟新,赖勇强,黄尚书,等.腔镜经胸乳入路与腔镜辅助颈部小切口甲状腺切除术炎性反应的对比研究[J].中国微创外科杂志,2014,14(8):707-710.
[5] 董效东,侯占富,王立坤,等.腔镜甲状腺部分切除术对患者机体炎性及免疫指标的影响[J].现代中西医结合杂志,2016,25(9):937-940.
[6] 樊津瑞,靳浩,杨君,等.超声引导下微波消融术与开放手术在甲状腺结节治疗中效果的比较[J].蚌埠医学院学报,2018,43(9):1159-1162,1165.
[7] 孙太冉,李秀芬,鲁蓓,等.传统甲状腺切除术与小切口甲状腺切除术治疗甲状腺结节的对比研究[J].山西医药杂志,2017,46(2):173-175.
[8] 王龙琦,陈坚,刘绪舜.微波消融术与传统开放手术在良性甲状腺结节治疗中对机体创伤影响的比较[J].中国微创外科杂志,2016,16(3):236-240.
[9] 宋延冰,姚中杨.乳晕入路全腔镜下甲状腺癌根治术与小切口甲状腺癌根治术的临床对比分析[J].腹腔镜外科杂志,2016,21(11):804-806.
[10] 郑力.改良小切口手术治疗老年甲状腺瘤疾病的临床观察[J].老年医学与保健,2017,23(2):125-127.
[11] 谷彬,钱军,张荧荧,等.超声刀辅助下低领小切口甲状腺手术的临床分析[J].大连医科大学学报,2016,38(6):562-564.
[12] 连红霞,李秀刚,闫建平.小切口与传统开放手术治疗甲状腺腺瘤效果对比研究[J].中国现代普通外科进展,2017,20(4):291-292.
[13] 倪鹏,李红阳.腔镜辅助颈部小切口手术治疗甲状腺良性肿瘤的临床效果[J].中国医药导报,2016,13(16):35-37,49.
[14] 贺功建,李凡,任章霞,等.小切口改良甲状腺切除术与传统甲状腺切除术的临床疗效对比[J].现代生物医学进展,2016,16(14):2738-2740,2762.
[15] 张会英,袁培江,源洋,等.清蛋白与前清蛋白和C-反应蛋白检测对普外科患者术后感染的诊断研究[J].中华医院感染学杂志,2017,27(20):4716-4719.
[16] 陈志军,陈志兴,牛志国,等.开放手术治疗甲状腺结节对患者炎症因子的影响[J].中国现代医生,2017,55(19):53-56.
[2] 王隽,权红光.低位小切口切除术治疗甲状腺瘤的疗效及安全性分析[J].实用癌症杂志,2016,31(8):1314-1316.
[3] 伍盛华,余洁芳,容宽朝.手术治疗甲状腺结节370例的临床分析[J].广西医学,2014,36(7):992-994.
[4] 梁伟新,赖勇强,黄尚书,等.腔镜经胸乳入路与腔镜辅助颈部小切口甲状腺切除术炎性反应的对比研究[J].中国微创外科杂志,2014,14(8):707-710.
[5] 董效东,侯占富,王立坤,等.腔镜甲状腺部分切除术对患者机体炎性及免疫指标的影响[J].现代中西医结合杂志,2016,25(9):937-940.
[6] 樊津瑞,靳浩,杨君,等.超声引导下微波消融术与开放手术在甲状腺结节治疗中效果的比较[J].蚌埠医学院学报,2018,43(9):1159-1162,1165.
[7] 孙太冉,李秀芬,鲁蓓,等.传统甲状腺切除术与小切口甲状腺切除术治疗甲状腺结节的对比研究[J].山西医药杂志,2017,46(2):173-175.
[8] 王龙琦,陈坚,刘绪舜.微波消融术与传统开放手术在良性甲状腺结节治疗中对机体创伤影响的比较[J].中国微创外科杂志,2016,16(3):236-240.
[9] 宋延冰,姚中杨.乳晕入路全腔镜下甲状腺癌根治术与小切口甲状腺癌根治术的临床对比分析[J].腹腔镜外科杂志,2016,21(11):804-806.
[10] 郑力.改良小切口手术治疗老年甲状腺瘤疾病的临床观察[J].老年医学与保健,2017,23(2):125-127.
[11] 谷彬,钱军,张荧荧,等.超声刀辅助下低领小切口甲状腺手术的临床分析[J].大连医科大学学报,2016,38(6):562-564.
[12] 连红霞,李秀刚,闫建平.小切口与传统开放手术治疗甲状腺腺瘤效果对比研究[J].中国现代普通外科进展,2017,20(4):291-292.
[13] 倪鹏,李红阳.腔镜辅助颈部小切口手术治疗甲状腺良性肿瘤的临床效果[J].中国医药导报,2016,13(16):35-37,49.
[14] 贺功建,李凡,任章霞,等.小切口改良甲状腺切除术与传统甲状腺切除术的临床疗效对比[J].现代生物医学进展,2016,16(14):2738-2740,2762.
[15] 张会英,袁培江,源洋,等.清蛋白与前清蛋白和C-反应蛋白检测对普外科患者术后感染的诊断研究[J].中华医院感染学杂志,2017,27(20):4716-4719.
[16] 陈志军,陈志兴,牛志国,等.开放手术治疗甲状腺结节对患者炎症因子的影响[J].中国现代医生,2017,55(19):53-56.