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全甲状腺切除术或近全甲状腺切除术治疗甲状腺癌

Total or Near-total Thyroidectomy in treatment of Thyroid Cancer.

作者信息

Li Gang, Wu Lihong

机构信息

Gang Li, Department of General Surgery, The First Affiliated Hospital of Qiqihar Medical College, Qiqihar 161041, Heilongjiang, China.

Lihong Wu Department of General Surgery, The First Affiliated Hospital of Qiqihar Medical College, Qiqihar 161041, Heilongjiang, China.

出版信息

Pak J Med Sci. 2022 Jul-Aug;38(6):1662-1667. doi: 10.12669/pjms.38.6.5765.

Abstract

OBJECTIVES

To observe the clinical efficacy on total or near-total thyroidectomy in the treatment of thyroid cancer.

METHODS

Ninety-four patients with thyroid cancer treated in Meiris Branch of the First Affiliated Hospital of Qiqihar Medical College from June 2018 to June 2020 were selected as subjects. According to different surgical methods, they were divided into observation group and control group, with 47 patients in each group. The control group was treated with total thyroidectomy, while the observation group received near-total thyroidectomy. The two groups were both followed up for one year. The therapeutic effect, surgery-related indexes (surgical duration, intraoperative bleeding volume, postoperative analgesia time and postoperative 24-h VAS score), the incidence of complications three months after surgery, and the serum levels of relevant indexes [parathyroid hormone (PTH), calcium ion (Ca) and signal transducer and activator of transcription 3 (STAT3)] before and 14 d after surgery were compared between the two groups. The difference in quality of life [the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)] between the two groups one year after surgery was observed.

RESULTS

During the one year follow-up, there was no death in both groups. The total efficacy of the observation group was higher than that of the control group (0.05). The surgical duration, postoperative analgesia time and postoperative 24-h VAS score of the observation group were higher than those of the control group (<0.05). However, no statistically significant difference was found in intraoperative bleeding volume between the two groups ( 0.05). Three months after surgery, the total incidence of postoperative complications in the observation group was higher than that in the control group ( 0.05). Fourteen days after surgery, the levels of PTH, Ca and STAT3 in the two groups were lower than those before surgery, and the levels in the observation group were lower than those in the control group ( 0.05). One year after surgery, cognitive, emotional, role, social and physical scores in the observation group were all lower than those in the control group, without statistically significant differences ( 0.05).

CONCLUSION

Total thyroidectomy is effective in the treatment of thyroid cancer, but has many postoperative complications. Clinicians need to choose the appropriate surgical method according to the actual condition of patients.

摘要

目的

观察全甲状腺切除术或近全甲状腺切除术治疗甲状腺癌的临床疗效。

方法

选取2018年6月至2020年6月在齐齐哈尔医学院第一附属医院梅里斯分院接受治疗的94例甲状腺癌患者作为研究对象。根据手术方式不同,将其分为观察组和对照组,每组47例。对照组采用全甲状腺切除术治疗,观察组采用近全甲状腺切除术治疗。两组均随访1年。比较两组的治疗效果、手术相关指标(手术时间、术中出血量、术后镇痛时间及术后24小时视觉模拟评分法(VAS)评分)、术后3个月并发症发生率以及手术前和术后14天相关指标[甲状旁腺激素(PTH)、钙离子(Ca)和信号转导子与转录激活子3(STAT3)]的血清水平。观察两组术后1年生活质量[欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)]的差异。

结果

随访1年期间,两组均无死亡病例。观察组的总有效率高于对照组(P<0.05)。观察组的手术时间、术后镇痛时间及术后24小时VAS评分均高于对照组(P<0.05)。然而,两组术中出血量比较差异无统计学意义(P>0.05)。术后3个月,观察组术后并发症总发生率高于对照组(P<0.05)。术后14天,两组PTH、Ca及STAT3水平均低于术前,且观察组低于对照组(P<0.05)。术后1年,观察组的认知、情感、角色、社会及躯体评分均低于对照组,但差异无统计学意义(P>0.05)。

结论

全甲状腺切除术治疗甲状腺癌有效,但术后并发症较多。临床医生需根据患者实际情况选择合适的手术方式。

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Total or Near-total Thyroidectomy in treatment of Thyroid Cancer.
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