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.
引文
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