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外科研究与新技术（中英文）

外科研究与新技术 ›› 2016, Vol. 5 ›› Issue (2): 85-87.

• 论著 • 上一篇    下一篇

不同手术方案对甲状腺肿瘤患者围术期应激及机体免疫功能的影响

黄钰   

  1. 河南省直第三人民医院
  • 收稿日期:2016-03-17 修回日期:2016-03-17 出版日期:2016-06-28 发布日期:2016-09-13
  • 通讯作者: 黄钰 E-mail:shaoshangke_zhao@sina.com

Effects of different operation plans on stress and immune function in patients with thyroid tumor during perioperative period

  • Received:2016-03-17 Revised:2016-03-17 Online:2016-06-28 Published:2016-09-13

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摘要： 摘要 目的 探讨不同手术方案对甲状腺肿瘤患者围术期应激及机体免疫功能的影响。 方法 选取2013年3月-2015年3月期间来我院就诊的甲状腺肿瘤患者77例，按手术方案分为研究组41例和对照组36例，研究组在腔镜辅助下行颈部小切口手术，对照组行传统开放手术。观察两组手术基本情况包括手术时间、术中出血量、住院时间，并比较两组患者围术期应激及机体免疫功能相关指标的差异，包括CD3+、CD4+、体温及C反应蛋白（CRP）浓度。结果 观察组手术时间（42.43±11.02）min、住院时间（34.20±8.32）ml均显著较短于对照组，手术出血量（4.16±0.65）d显著低于对照组（P＜0.05）；术前24h两组体温、CRP、CD3+、CD4+比较均无统计学意义（P＞0.05），观察组术后最高体温（36.46±0.21）。C显著低于对照组，术后48h、72h CRP（20.29±1.39）mg/L、（12.46±1.70）mg/L显著低于对照组（P＜0.05）；观察组术后48h CD3+显著高于对照组（P＜0.05），但两组术后48h CD3+及术后48h、72h CD4+比较均无明显差异（P＞0.05）。结论 与传统开放手术相比，腔镜辅助颈部小切口手术治疗甲状腺肿瘤患者手术时间、住院时间更短、术中出血量更少，对患者应激反应影响较小，两种手术方案对患者机体免疫功能的影响无显著差异，因此临床上可优先选择腔镜辅助颈部小切口手术治疗甲状腺肿瘤患者。

关键词: 甲状腺手术, 甲状腺肿瘤, 应激反应, 免疫功能

Abstract: [Abstract] Objective To explore effects of different operation plans on stress and immune function in patients with thyroid tumor during perioperative period. Methods 77 cases of patients with thyroid tumor in our hospital from March 2013 to March 2015 were selected, according to the operation plans, 41 cases were divided into study group and 36 cases in control group. The study group was given endoscope-assisted neck micro-incision treatment while the control group was given traditional open surgery. The basic situation of operation in the two groups, including operation time, intraoperative blood loss, hospitalization time were observed, and differences of perioperative stress and immune function related indexes between the two groups were compared , including CD3+, CD4+, body temperature and C reactive protein (CRP) level. Results The operation time (42.43±11.02)min and hospitalization time (34.20±8.32)ml in the observation group were significantly shorter than that in the control group, intraoperative blood loss (4.16±0.65)d was significantly lower than that in the control group ( P < 0.05); there was no significant difference in preoperative 24h body temperature, CRP, CD3+ and CD4+ ( P > 0.05), the highest postoperative temperature in the observation group was (36.46±0.21)degree, which was significantly lower than that in the control group, 48 and 72 hours after operation, CRP in the the observation group were (20.29±1.39)mg/L, (12.46±1.70)mg/L, which were significantly lower than the control group ( P < 0.05); 48h after operation, CD3+ in the observation group was significantly higher than that of the control group ( P < 0.05), but there were no significant differences in CD3+ (48h after operation) and CD4+ (48h and 72h after operation) between the two groups ( P > 0.05). Conclusion Compared with traditional open surgery, endoscope-assisted neck micro-incision treatment for patients with thyroid tumor can make operation time and hospitalization time shorter, intraoperative blood loss fewer, influence on the stress reaction of patients less, there was no significant difference in the influence on the immune function of the patients between two types of operation plans, so endoscope-assisted neck micro-incision treatment can be a priority selection for patients with thyroid tumor in clinic.

Key words: Thyroid surgery, Thyroid tumor, Stress response, Immune function