完全腔镜下与开放性甲状腺癌根治术对机体应激反应的影响

发布时间：2018-01-02 10:19

本文关键词：完全腔镜下与开放性甲状腺癌根治术对机体应激反应的影响　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:比较完全腔镜下甲状腺癌根治术与开放性甲状腺癌根治术对机体产生的应激反应的强度,间接反映两种手术方式对机体创伤大小。方法:选择新疆医科大学附属中医医院2015年6月至2016年9月间的甲状腺癌患者94例,分为2组。腔镜组48例行完全腔镜下胸、乳路径甲状腺癌根治术;另外46例患者行传统开放性甲状腺癌根治术,为对照组。检测指标为血清白细胞介素-6和C反应蛋白,抽血时点为术前一天、术后2小时、术后24小时、术后72小时。结果:1.术前血清IL-6、CRP水平腔镜组和开放组相比较差异无统计学意义(P0.05);2.2组患者术后2小时IL-6水平升至峰值,术后24h、72hIL-6水平与术后2小时值相比,呈下降趋势,逐渐回落,两组间比较差异无统计学意义(P0.05)。3.术后各时段两组间血清CRP水平逐渐升高,呈上升趋势,在术后72h时达到高值,术后2小时CRP值相比较差异无统计学意义(P0.05);两组术后24小时、72小时血清CRP值相比较差异有统计学意义(P0.05)。结论:完全腔镜下甲状腺癌根治术对血清应激细胞因子影响更小,且手术切口更加隐蔽及美观,给患者带来的机体及心理上的创伤更小。
[Abstract]:Objective: to compare the intensity of stress response between radical thyroidectomy and open radical thyroidectomy. Methods: 94 patients with thyroid cancer were selected from June 2015 to September 2016 in TCM Hospital affiliated to Xinjiang Medical University. The patients in the endoscopic group were divided into 2 groups. 48 patients in the endoscopic group underwent radical resection of thyroid carcinoma with complete endoscopic approach. The other 46 patients were treated with traditional open thyroid cancer radical operation as control group. The serum levels of interleukin-6 and C-reactive protein were measured. The blood sampling time was one day before operation, 2 hours after operation and 24 hours after operation. Results at 72 hours postoperatively, there was no significant difference in serum levels of IL-6 and CRP between the endoscopic group and the open group (P 0.05). The level of IL-6 rose to the peak at 2 hours after operation, and the level of IL-6 at 24 hours and 72 hours after operation showed a downward trend and gradually decreased compared with the value of 2 hours after operation. There was no significant difference between the two groups (P0.05. 3). The serum CRP level of the two groups increased gradually and showed an upward trend at 72 hours after operation, and reached a high value at 72 hours after operation. There was no significant difference in CRP between two hours after operation (P 0.05). There was significant difference in serum CRP between the two groups at 24 hours and 72 hours postoperatively (P 0.05). Conclusion: the effect of radical resection of thyroid carcinoma under complete endoscopy on serum stress cytokines is less. The surgical incision is more subtle and beautiful, and brings less trauma to the patients.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.1

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