摘要
目的探讨胸乳入路腔镜甲状腺癌根治术与开放手术对患者创伤应激因子与CD4^(+)T淋巴细胞(以下简称“CD4^(+)”)、CD8^(+)T淋巴细胞(以下简称“CD8^(+)”)水平的影响。方法随机选取2020年1—12月福建医科大学附属福州市第一医院收治的36例甲状腺癌患者为对象,用随机抽签法分为两组(对照组和观察组),各18例。对照组予以传统开放手术,观察组予以胸乳入路腔镜术。比较两组手术情况、手术前后CD4^(+)和CD8^(+)水平、创伤应激因子水平及并发症发生情况。结果两组手术时间对比,差异无统计学意义(P>0.05);观察组术中出血量为(3.84±1.98)mL,术后引流量为(30.23±9.48)mL,均少于对照组的(10.68±1.63)、(66.58±11.58)mL,差异有统计学意义(t=11.315、10.305,P均<0.05)。术后3 d,两组CD4^(+)、CD8^(+)水平较术前相比均有所改善,且观察组改更为明显,差异有统计学意义(P均<0.05)。术后3 d,两组肿瘤坏死因子α、白细胞介素6、超敏C反应蛋白水平较术前均有所上升,但观察组低于对照组,差异有统计学意义(P均<0.05)。两组术后并发症总发生率对比,差异无统计学意义(P>0.05)。结论相比传统开放手术治疗,应用胸乳入路腔镜术于甲状腺癌患者中效果更为显著,具有术中出血量少、术后引流量少等优势,且有效改善患者创伤应激情况。
Objective To investigate the effects of endoscopic radical thyroidectomy and open surgery on the levels of traumatic stress factors,CD4^(+)T cells(CD4^(+))and CD8^(+)T cells(CD8^(+)).Methods A total of 36 patients with thyroid can-cer treated in Fuzhou First Hospital Affiliated to Fujian Medical University from January to December 2022 were ran-domly selected as the study objects and were divided into two groups(control group and observation group)according to random drawing method,with 18 cases in each group.The control group received traditional open surgery,and the observation group received endoscopic radical thyroidectomy.The operative conditions,levels of CD4^(+)and CD8^(+),trau-matic stress factor and complications were compared between the two groups.Results There was no statistically signifi-cant difference in operation time between the two groups(P>0.05).The intraoperative blood loss was(3.84±1.98)mL and the postoperative drainage volume was(30.23±9.48)mL in the observation group,which were lower than(10.68±1.63)mL and(66.58±11.58)mL in the control group,the differences were statistically significant(t=11.315,10.305,both P<0.05).3 d after operation,the levels of CD4^(+)and CD8^(+)improved in both group,and the improvement was more significant in the observation group,the differences were statistically significant(both P<0.05).3 d after operation,the levels of tumor necrosis factor-α,interleukin-6 and hypersensitive c-reactive protein in both groups were higher than those before operation,but the levels of the observation group were lower than those of the control group,the differ-ences were statistically significant(all P<0.05).There was no statistically significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with traditional open surgery,endoscopic radical thyroidectomy has a more significant effect on thyroid cancer patients,with advantages such as less intraoperative blood loss and less postoperative drainage flow,and effectively improves the traumatic stress of patients.
作者
黄利勇
HUANG Liyong(Department of General Surgery,Fuzhou First Hospital Affiliated to Fujian Medical University,Fuzhou,Fujian Prov-ince,350009 China)
出处
《中外医疗》
2024年第6期33-36,48,共5页
China & Foreign Medical Treatment
关键词
胸乳入路腔镜术
甲状腺癌
创伤应激因子
术中出血量
并发症
Endoscopic radical thyroidectomy
Thyroid cancer
Traumatic stress factor
Intraoperative blood loss
Complication
