经腋窝入路无充气腔镜下手术对早期甲状腺肿瘤患者免疫功能及美容效果的影响

Impact of transaxillary approach on the immune function and aesthetic effect of early thyroid tumor with airless endoscopy

摘要:

目的 探讨经腋窝入路无充气腔镜下手术对早期甲状腺肿瘤患者免疫功能及美容效果的影响。方法 选取2019年5月－2021年6月该院收治的98例早期甲状腺肿瘤患者为研究对象，随机分为观察组和对照组，观察组（n = 49）给予经腋窝入路无充气腔镜手术，对照组（n = 49）给予开放性甲状腺肿瘤切除术。对比两组患者手术相关指标、淋巴结清除效果、免疫功能、并发症发生率及术后3个月美容效果。结果 观察组术中出血量为（12.27±4.53）mL，术后引流量为（78.25±19.36）mL，明显少于对照组的（23.71±6.86）和（136.24±45.28）mL（均P < 0.05）。观察组手术时间为（110.16±11.57）min，明显长于对照组的（61.34±6.27）min（P < 0.05）。观察组淋巴结清扫数目为（2.02±1.03）枚，与对照组的（1.98±1.05）枚比较，差异无统计学意义（P > 0.05）。术后1周，观察组CD3⁺为（56.84±5.06）%，CD4⁺为（33.72±4.08）%，明显高于对照组的（50.26±4.87）%和（28.15±3.97）%（均P < 0.05），而观察组CD8⁺为（35.14±5.32）%，明显低于对照组的（38.29±5.76）%（P < 0.05）。观察组并发症发生率为0.00%，明显低于对照组的8.16%，但差异无统计学意义（P > 0.05）。观察组美容满意度为97.96%，明显高于对照组的81.63%（P < 0.05）。结论 经腋窝入路无充气腔镜下手术治疗早期甲状腺肿瘤患者，能改善手术指标和免疫功能，降低并发症发生率，并提高美容满意度。

Abstract:

Objective To investigate the impact of transaxillary approach on immune function and aesthetics of early thyroid tumors with airless endoscopy.Methods 98 patients with early thyroid from May 2019 to June 2021 were selected as the research objects. They were randomly divided into the observation group (n = 49) who was given transaxillary approach without air-filled cavity endoscopic surgery, and the control group (n = 49) who was given open thyroid tumor resection. The operation-related indicators, lymph node removal effect, immune function, complication rate and cosmetic effect 3 months after surgery were compared between the two groups.Results The intraoperative blood loss was (12.27 ± 4.53) mL and postoperative drainage volume was (78.25 ± 19.36) mL of the observation group, there were significantly less than those of the control group (23.71 ± 6.86) mL and (136.24 ± 45.28) mL (all P < 0.05). The operation time of the observation group was (110.16 ± 11.57) min, there was significantly longer than that in the control group (61.34 ± 6.27) min (P < 0.05). The number of dissected lymph nodes in the observation group (2.02 ± 1.03) and the control group (1.98 ± 1.05) had no significant difference (P > 0.05). One week after operation, CD3⁺(56.84 ± 5.06) % and CD4⁺(33.72 ± 4.08) % in the observation group were significantly higher than those in the control group (50.26 ± 4.87) % and (28.15 ± 3.97) % (all P < 0.05). The CD8⁺ in observation group (35.14 ± 5.32) % was significantly lower than in the control group (38.29 ± 5.76) % (P < 0.05). The incidence of complications in the observation group (0.00%) was significantly lower than that in the control group (8.16%), however, the difference was not statistically significant (P > 0.05). The cosmetic satisfaction of the observation group (97.96%) was significantly higher than that of the control group (81.63%) (P < 0.05).Conclusion Transaxillary approach without pneumatic endoscopy can significantly improve surgical indicators and immune function in patients with early thyroid tumors, reduce patient complications, and improve cosmetic satisfaction.