南方医科大学学报2017，Vol.37Issue(10)：1364-1369,6.DOI:10.3969/j.issn.1673-4254.2017.10.13
腔镜与开放手术在甲状腺近全切除术后引流量与全身创伤反应的对比
Comparison of postoperative drainage and systemic trauma response after endoscopic and traditional near total thyroidectomy
张永泉 1黎志超 1陈飞 1汪红娟 1李强1
作者信息
- 1. 南方医科大学珠江医院普通外科,广东 广州510282
- 折叠
摘要
Abstract
Objective To investigate the difference of postoperative drainage and systemic trauma response between endoscopic and traditional near total thyroidectomy to provide the basis for selecting appropriate operative methods. Methods In this prospective clinical controlled study,80 patientsscheduled for near total bilateral thyroidectomy for the first time were divided equally into endoscopic surgery group (group A) and open surgery group (group B). The total drainage volume after operation, postoperative extubation time, and postoperative daily drainage volume were recorded after the operation. The contents of triglyceride (TG) and total protein (TP) were determined in the postoperative drainage fluid onthe first day. The levels of interleukin-6 (IL-6), high-sensitive C reactive protein (HS-CRP), alpha 1-acid glycoprotein (AAG), ceruloplasmin (CER) and haptoglobin (HPT) in venous blood were tested before the operation and on the first day after surgery. Results Compared with those in group B, the postoperative drainage volumein group Aincreased significantly (P=0.000) and the postoperative extubation time was significantly prolonged (P=0.000); the mean postoperative daily drainage volume was significantly larger ingroup A than in group B (P=0.000) and tended to decrease with time in both groups. There was no significant difference in the content of triglycerideortotal protein in the drainage fluid between the two groups on the first day after operation(P=0.429 and 0.324,respectively).In both groups,the contents of AAG,ceruloplasmin and haptoglobin on the first postoperative day were all similar with those measurement before operation(P>0.05),but significant variations occurred in the levels of IL-6 and HS-CRP on the first postoperative day (P=0.000). The serum levels of IL-6 or HS-CRP did not differ significantly between the two groups on the first day after operation(P=0.054 and 0.066,respectively).Conclusion Compared with open surgery, endoscopic near total bilateral thyroidectomyis associated with an increased the volume of postoperative drainage and a prolonged time of extubationbut not an increased systemic trauma response. Therefore, endoscopic surgery can serve as one of the routine options for patients who are concerned with neckscars resulting from open surgeries.关键词
甲状腺近全切除术/腔镜手术/引流液/全身创伤反应/炎症指标Key words
near total thyroidectomy/endoscopic surgery/drainage fluid/systemic trauma response/inflammation index引用本文复制引用
张永泉,黎志超,陈飞,汪红娟,李强..腔镜与开放手术在甲状腺近全切除术后引流量与全身创伤反应的对比[J].南方医科大学学报,2017,37(10):1364-1369,6.
