摘要【目的】探讨经胸乳入路甲状腺良性肿瘤切除的疗效以及对患者预后的影响。【方法】回顾性分析2015年11月至2017年12月在本院接受治疗的甲状腺良性肿瘤患者90例,根据治疗方式分为观察组和对照组,每组45例。观察组患者给予经胸乳入路切除手术治疗,对照组患者行传统开放手术治疗。比较两组患者手术相关指标情况,两组患者手术前后血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)以及疼痛视觉模拟评分(VAS)变化及两组患者术后并发症情况。【结果】观察组患者的术中出血量、术后引流量低于对照组,两组比较差异有显著性( P <0.05)。观察组患者的手术时间、术后住院时间短于对照组,而住院费用以及美容评分高于对照组,两组比较差异均有统计学意义( P <0.05)。两组患者术后的IL-6以及TNF-α水平表达都有所提高,而观察组提高幅度高于对照组,两组比较差异均有统计学意义( P <0.05);观察组出现切口疼痛、声音嘶哑、皮下积液、术后出血等并发症发生率低于对照组,其差异有统计学意义(8.89% vs 82.2%, χ2 =48.7855, P <0.05)。【结论】采用经胸乳入路手术治疗甲状腺良性肿瘤能够有效提高患者血清IL-6和TNF-α水平,缩短住院时间,有效降低其术后并发症发生率,值得临床推广应用。
Abstract：【Objective】 To investigate the therapeutic effect and prognosis of patients with benign thyroid tumor resection via transthoracic approach. 【Methods】A total of 90 patients with benign thyroid tumor treated in our hospital from November 2015 to December 2017 were retrospectively analyzed. They were divided into observation group and control group according to the treatment method, 45 cases in each group. The patients in the observation group were treated with transthoracic and mammary surgery, while the patients in the control group were treated with traditional open surgery. The operation related indexes, serum interleukin-6 (IL-6), tumor necrosis factor -α(TNF -α), visual analogue scale (VAS) and postoperative complications were compared between the two groups【Results】The intraoperative blood loss and postoperative drainage of the observation group were lower than those of the control group, with significant difference between the two groups ( P <0.05). The operation time and postoperative hospital stay of the observation group were shorter than those of the control group, while the hospitalization expenses and beauty score of the observation group were higher than those of the control group, and the differences between the two groups were statistically significant ( P <0.05). The expression of IL-6 and TNF -αin the two groups after operation were improved, while the improvement in the observation group was higher than that in the control group, and the difference was statistically significant ( P <0.05); the incidence of incision pain, hoarseness, subcutaneous effusion, postoperative bleeding and other complications in the observation group was lower than that in the control group, and the difference was statistically significant (8.89% vs 82.2%, χ2 = 48.7855, P <0.05).【Conclusion】Transthoracic and mammary surgery for benign thyroid tumor can effectively improve the serum IL-6 and TNF -αlevels, shorten the hospital stay, and effectively reduce the incidence of postoperative complications, which is worthy of clinical application.
2021, Vol. 38 
