| 侯修强,冯创,黄文连,等.基于倾向性评分匹配比较不同术式治疗甲状腺微小乳头状癌的效果[J].安徽医药,2023,27(11):2186-2190. |
| 基于倾向性评分匹配比较不同术式治疗甲状腺微小乳头状癌的效果 |
| Comparision of effect of different surgical methods in the treatment of papillary thyroid microcarcinoma based on propensity score matching analysis |
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| DOI：10.3969/j.issn.1009-6469.2023.11.014 |
| 中文关键词: 甲状腺切除术 内窥镜手术 倾向评分匹配 口腔前庭入路 开放手术 甲状腺微小乳头状癌 |
| 英文关键词: Thyroidectomy Endoscopic surgery Propensity score matching Oral vestibular approach Open surgery Papillary thyroid microcarcinoma |
| 基金项目:武汉市卫生和计划生育委员会科研项目( WX16C30) |
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| 中文摘要: |
| 目的对比不同术式治疗甲状腺微小乳头状癌( PTMC)的效果。方法回顾性分析 2019年 6月至 2021年 5月武汉科技大学附属武汉市武昌医院接收的择期手术治疗的 PTMC病人 157例，其中经口腔前庭入路腔镜甲状腺手术( TOETVA)组 63例，行 TOETVA，开放组 94例，行开放术式甲状腺手术。应用基线资料对病人进行 1∶1倾向性评分匹配(PSM)最终纳入 TOETVA组、开放组各 56例。比较两组围术期指标、血清指标、美观度及术后并发症发生率。结果 TOETVA组手术，用时［(65.03±5.25)min比( 53.72±6.46)min］住院时间［(7.25±1.46)d比( 5.72±1.12)d］明显较开放组长( P<0.05)清扫中央区淋巴结( CLN)个数［(7.57±1.61)个比( 6.36±1.48个］明显较开放组多( P<0.05)术后引流量［(73.16±16.58)mL比.41±14.06)mL］明显较开放组大( P<0.05)术后 24 h疼痛数字评分法( NRS)评分［( 5.02±17)分比( 6.24±1.50)分］明显较开放组低( P<0.05)； TOETVA组术后 24 h C反蛋白( CRP)水平明显较开放组低( P<0.05)甲状旁腺激素( PTH)、白细胞( WBC)和开放组比较差异无统计学意义( P>0.05)； TOETVA组温哥华瘢痕评定量表( VSS)为( 2.05±0.61)分，明显较开放组的( 5.23±0.87)分低( P<0.05)； )、(62，.3，应，评分，TOETVA组并发症发生率 10.71%和开放组的 17.86%比较差异无统计学意义( P>0.05)。结论和开放手术相比， TOETVA的手术用时及 TOETVA病人住院时间更长，但其清扫 CLN的效果更好，病人术后疼痛度更轻，且美观度更高。 |
| 英文摘要: |
| Objective To compare the effects of different surgical methods in the treatment of papillary thyroid microcarcinoma (PTMC). Methods A retrospective analysis was performed on 157 patients with PTMC who underwent elective surgery in WuhanWuchang Hospital affiliated to Wuhan University of Science and Technology from June 2019 to May 2021. Among them, 63 patientswho underwent endoscopic thyroid surgery via oral vestibular approach (TOETVA) were included in the TOETVA group, and 94 patients who underwent open surgery were included in the open group. After PSM matching for baseline data of patients, 56 cases in eachgroup were finally included. The perioperative indexes, serum indexes, aesthetic appearance and postoperative complication rate werecompared between the two groups.Results The operation time [(65.03±5.25) min vs. (53.72±6.46) min] and hospital stay [(7.25±1.46) d vs. (5.72±1.12) d] in the TOETVA group were significantly longer than those in the open group (P<0.05), the number of dissected central lymph node (CLN) was significantly higher than that in the open group [(7.57±1.61) vs. (6.36±1.48)] (P<0.05), the postoperative drainage volume was significantly larger than that in the open group [(73.16±16.58) mL vs. (62.41±14.06) mL] (P<0.05), the pain Numerical Rating Scale (NRS) score at 24 h after operation was lower than that in the open group [(5.02±1.37) vs. (6.24±1.50)] (P<0.05); the level of C-reactive protein (CRP) at 24 h after operation in the TOETVA group was lower than that in the open group (P<0.05), while there was no difference in parathyroid hormone (PTH),white blood cell (WBC) between the two groups (P>0.05); the VancouverScar Scale (VSS) score of the TOETVA group was (2.05±0.61) points, which was lower than that of the open group (5.23±0.87) points (P <0.05); the complication rate had no statistical difference between the TOETVA group (10.71 %) and open group (17.86 %) (P>0.05). Conclusion Compared with open surgery, the operation time of TOETVA and the hospitalization time of TOETVA patients are longer,but the effect of dissection of CLN is better, the postoperative pain of patients is lighter, and the appearance is better. |
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