微波消融与腔镜手术治疗甲状腺肿瘤的效果及对炎症指标的影响分析

巫浩荣 李晓辉 王锦祥 张建 王超

【摘要】 目的：探討微波消融与腔镜手术治疗甲状腺肿瘤的效果及对炎症指标的影响。方法：选取2019年10月-2020年10月本院收治的115例甲状腺肿瘤患者为研究对象。根据手术方式不同将患者分为消融组（n=43）和腔镜组（n=72）。消融组采用微波消融术治疗，腔镜组采用经双侧胸乳入路腔镜甲状腺次全切除术治疗。比较两组治疗效果及对炎症指标的影响。结果：消融组手术时间、住院时间均短于腔镜组，术中出血量少于腔镜组，差异均有统计学意义（P<0.05）。术前和术后24 h，两组血清TT3、TT4、TSH水平比较，差异均无统计学意义（P>0.05）。术后24 h，消融组WBC、CRP、PCT水平均低于腔镜组，差异均有统计学意义（P<0.05）。术后24 h，两组WBC、CRP水平均高于治疗前，PCT水平均低于治疗前，差异均有统计学意义（P<0.05）。两组均未出现无效病例。消融组显效率为83.72%，高于腔镜组的65.28%，差异有统计学意义（P<0.05）。消融组并发症发生率为6.98%，低于腔镜组的20.83%，差异有统计学意义（P<0.05）。结论：与腔镜手术相比，微波消融治疗甲状腺肿瘤效果较显著，并发症较少，且对机体的创伤小，炎症反应较轻，能有效促进患者康复，缩短住院时间。

【关键词】 微波消融 腔镜手术 甲状腺肿瘤 炎症

Effect of Microwave Ablation and Endoscopic Surgery on Thyroid Tumors and Its Influence on Inflammatory Indexes/WU Haorong， LI Xiaohui， WANG Jinxiang， ZHANG Jian， WANG Chao. //Medical Innovation of China， 2021， 18（27）： 0-048

[Abstract] Objective： To investigate the effect of microwave ablation and endoscopic surgery in the treatment of thyroid tumors and its effect on inflammatory indexes. Method： A total of 115 patients with thyroid tumor admitted to our hospital from October 2019 to October 2020 were selected as the research objects. Patients were divided into ablation group （n=43） and endoscopic group （n=72） according to different surgical methods. Ablation group was treated with microwave ablation， the endoscopic group was treated with endoscopic subtotal thyroidectomy via bilateral thoraco mammary approach. The therapeutic effect and the influence on inflammatory indexes were compared between the two groups. Result： The surgical duration and hospital stay of the ablation group were shorter than those of the endoscopic group， the intraoperative blood loss was less than that of the endoscopic group， the differences were statistically significant （P<0.05）. Before and 24 h after surgery， comparison of serum TT3， TT4 and TSH levels between the two groups， there were no significant differences （P>0.05）. 24 h after surgery， the levels of WBC， CRP and PCT in the ablation group were lower than those in the endoscopic group， the differences were statistically significant （P&lt;0.05）. 24 h after surgery， the levels of WBC and CRP in the two groups were higher than those before treatment， the levels of PCT were lower than those before treatment， the differences were statistically significant （P<0.05）. No invalid cases were found in both groups. The significant efficiency of the ablation group was 83.72%， which was higher than 65.28% of the endoscopic group， the difference was statistically significant （P<0.05）. The complication rate of the ablation group was 6.98%， which was lower than 20.83% of the endoscopic group， the difference was statistically significant （P<0.05）. Conclusion： Compared with endoscopic surgery， microwave ablation is more effective in the treatment of thyroid tumors， less complications， less trauma to the body and less inflammatory reaction， it can effectively promote the rehabilitation of patients and shorten the length of hospital stay.

[Key words] Microwave ablation Endoscopic surgery Thyroid tumors Inflammation

First-author’s address： Puning People’s Hospital， Puning 515300， China

doi：10.3969/j.issn.1674-4985.2021.27.012

甲状腺肿瘤是临床上的常见疾病，多表现为良性，临床上常采用手术切除进行治疗[1]。而传统的甲状腺肿瘤切除手术对患者造成的创面较大，术后并发症发生率也较高，严重影响患者的术后生活质量[2]。随着医疗技术的进步，患者不再只注重于手术的疗效，对术后的外观形象也有了更高要求[3]。……