| 许正强,吴兴桂,朱军华,沈 泉,余永豪.经口腔前庭入路与经乳晕入路腔镜甲状腺切除术对甲状腺微小乳头状癌VAS评分、创伤-免疫指标及美观程度的影响[J].,2023,(11):2135-2138 |
| 经口腔前庭入路与经乳晕入路腔镜甲状腺切除术对甲状腺微小乳头状癌VAS评分、创伤-免疫指标及美观程度的影响 |
| Effects of Transoral Vestibular Approach and Via Areola of Breasts Approach Endoscopic Thyroidectomy on VAS Score, Trauma-Immune Index and Aesthetic Degree of Thyroid Micropapillary Carcinoma |
| 投稿时间：2022-10-28 修订日期：2022-11-23 |
| DOI：10.13241/j.cnki.pmb.2023.11.026 |
| 中文关键词: 经口腔前庭入路 经乳晕入路 甲状腺切除术 甲状腺微小乳头状癌 疼痛 创伤指标 免疫指标 美观程度 |
| 英文关键词: Transoral vestibular approach Via areola of breasts approach Endoscopic thyroidectomy Thyroid micropapillary carcinoma Pain Trauma index Immune index Aesthetic degree |
| 基金项目:湖北省卫生和计划生育委员会科研项目（WJ2017F113） |
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| 中文摘要: |
| 摘要 目的：对比经口腔前庭入路腔镜甲状腺切除术（TOETVA）与经乳晕入路腔镜甲状腺切除术（ETE）对甲状腺微小乳头状癌疼痛视觉模拟（VAS）评分、创伤-免疫指标及美观程度的影响。方法：回顾性分析我院2020年3月~2021年12月期间接收的100例甲状腺微小乳头状癌患者的临床资料。按照入路方式的不同将患者分为A组（n=47，经ETE治疗）和B组（n=53，经TOETVA治疗）。对比两组围术期指标、创伤-免疫指标、美观程度及并发症发生率。结果：两组术中出血量、中央区淋巴结清扫数目、术后住院时间对比无差异（P>0.05）。B组的手术时间长于A组，术后第1 d颈部VAS评分低于A组（P<0.05）。两组术后3 d CD8+、白介素-6（IL-6）、C反应蛋白（CRP）、皮质醇（Cor）升高，但B组低于A组（P<0.05）。两组术后3 d CD4+下降，但B组高于A组（P<0.05）。B组的温哥华疤痕评定量表（VSS）评分、患者与观察者瘢痕评估量表（POSAS）评分均低于A组（P<0.05）。两组并发症发生率组间对比统计学差异不明显（P>0.05）。结论：与经ETE相比，经TOETVA治疗甲状腺微小乳头状癌，可获得与其相当的手术效果，且经TOETVA可更好地减轻术后疼痛、术后创伤，提高美观度。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effects of transoral endoscopic thyroidectomy vestibular approach (TOETVA) and via areola of breasts approach endoscopic thyroidectomy (ETE) on visual pain simulation (VAS) score, trauma-immune index and aesthetic degree of thyroid micropapillary carcinoma. Methods: The clinical data of 100 patients with thyroid micropapillary carcinoma who were received in our hospital from March 2020 to December 2021 were analyzed retrospectively. The patients were divided into group A (n=47, treated with ETE) and group B (n=53, treated with TOETVA) according to different approaches. Perioperative indexes, trauma-immune indexes, aesthetic degree and complication rate were compared in the two groups. Results: There were no differences between the two groups in the intraoperative blood loss, the number of central lymph nodes dissected and postoperative hospital stay (P>0.05). The operation time in the group B was longer than that in the group A, and the VAS score of the neck on the first day after operation was lower than that in the group A (P<0.05). CD8+, interleukin-6 (IL-6), C-reactive protein (CRP) and cortisol (Cor) increased in the two groups at 3 d after operation, but the group B was lower than the group A(P<0.05). CD4+ decreased in the two groups at 3 d after operation, but the group B was higher than the group A (P<0.05). The scores of Vancouver scar scale (VSS) and Patient and observer scar assessment scale (POSAS) in the group B were lower than those in the group A (P<0.05). There was no significant difference in the incidence of complications in the two groups(P>0.05). Conclusion: Compared with ETE, TOETVA can achieve a comparable surgical effect in the treatment of thyroid micropapillary carcinoma, and TOETVA can better reduce postoperative pain, postoperative trauma, and improve aesthetics. |
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