Jiang Yixue, Zhang Pan, Li Genpeng, Wei Tao, Lei Jianyong, Li Zhihui, Gou Juxiang
Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
West China School of Nursing, Sichuan University, Chengdu, China.
Endocrine. 2025 Feb;87(2):667-674. doi: 10.1007/s12020-024-04034-5. Epub 2024 Oct 9.
Both endoscopic thyroid lobectomy and conventional thyroid lobectomy are effective modalities for treating papillary thyroid microcarcinoma (PTMC). However, their respective psychological and sleep quality ramifications in patients remain largely unexplored.
Patients diagnosed with PTMC who underwent thyroid lobectomy at our institution between July 15, 2021, and July 15, 2022, were prospectively recruited. Psychological distress and sleep quality were assessed at five intervals (hospital admission, hospital discharge, and 1, 3, and 6 months posttreatment) utilizing four validated scales. The PTMC patients who completed the questionnaires diligently were subsequently categorized into either the endoscopic thyroid lobectomy group (trial group) or the conventional thyroid lobectomy group (control group). A propensity score matching (PSM) cohort was then established to examine longitudinal and cross-sectional alterations in psychological parameters.
Out of 602 eligible PTMC patients, 560 individuals completed all the questionnaires diligently during the follow-up period (response rate: 93.02%). This cohort comprised 176 patients (31.43%) who underwent endoscopic thyroid lobectomy and 384 patients (68.57%) who underwent conventional thyroid lobectomy. Following PSM, a comprehensive set of 176 matched patient pairs was successfully established. Both groups of patients exhibited a decline in sleep quality throughout the 6-month postoperative follow-up period; however, patients in the control group experienced concomitant elevation in anxiety levels. The PSQI scores of patients in the control group were markedly higher than those in the trial group across all follow-up time points, whereas the HAMA, HADS, and HEI scale scores did not significantly differ between the two groups.
In terms of sleep quality and psychological well-being, endoscopic thyroid lobectomy is superior to conventional thyroid lobectomy for PTMC patients.
内镜甲状腺叶切除术和传统甲状腺叶切除术都是治疗甲状腺微小乳头状癌（PTMC）的有效方式。然而，它们对患者各自的心理和睡眠质量影响在很大程度上仍未得到充分研究。
前瞻性招募了2021年7月15日至2022年7月15日期间在我院接受甲状腺叶切除术且被诊断为PTMC的患者。使用四个经过验证的量表在五个时间点（入院、出院以及治疗后1、3和6个月）评估心理困扰和睡眠质量。随后，将认真完成问卷的PTMC患者分为内镜甲状腺叶切除术组（试验组）或传统甲状腺叶切除术组（对照组）。然后建立倾向评分匹配（PSM）队列，以检查心理参数的纵向和横断面变化。
在602例符合条件的PTMC患者中，560例患者在随访期间认真完成了所有问卷（应答率：93.02%）。该队列包括176例（31.43%）接受内镜甲状腺叶切除术的患者和384例（68.57%）接受传统甲状腺叶切除术的患者。经过PSM后，成功建立了一组176对匹配的患者。两组患者在术后6个月的随访期内睡眠质量均有所下降；然而，对照组患者的焦虑水平同时升高。在所有随访时间点，对照组患者的PSQI评分均显著高于试验组，而两组之间的HAMA、HADS和HEI量表评分无显著差异。
在睡眠质量和心理健康方面，内镜甲状腺叶切除术对PTMC患者优于传统甲状腺叶切除术。
