| 高峰,吕金,王子斌,等.负压创面干预对腔镜经胸乳入路甲状腺切除术后炎症水平及腔道并发症的影响[J].安徽医药,2025,29(5):1001-1005. |
| 负压创面干预对腔镜经胸乳入路甲状腺切除术后炎症水平及腔道并发症的影响 |
| Effect of negative pressure wound intervention on inflammation level and luminal complications after thyroidectomy through endoscopic transthoracic approach |
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| DOI：10.3969/j.issn.1009-6469.2025.05.029 |
| 中文关键词: 负压伤口疗法 甲状腺疾病 腔镜经胸乳入路甲状腺切除术 炎症因子 并发症 |
| 英文关键词: Negative-pressure wound therapy Thyroid disease Endoscopic thyroidectomy via breast and chest approach Inflam-matory cytokines Complication |
| 基金项目:廊坊市科学技术研究与发展计划项目( 2021013153) |
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| 中文摘要: |
| 目的观察负压创面干预对腔镜经胸乳入路甲状腺切除术后炎症水平及腔道并发症的影响。方法选取 2021年 1月至 2022年 3月河北中石油中心医院拟行腔镜经胸乳入路甲状腺切除术的甲状腺疾病 100例，根据随机数字表法将分为治疗组和对照组，治疗组进行负压创面治疗，对照组进行常规加压包扎，每组 50例。比较两组病人手术围术期指标、术后 1d、3d和 7d的疼痛程度(VAS评分)和 C反应蛋白( CRP)、肿瘤坏死因子 α(TNF-α)白细胞介素(IL)-6、IL-1β、IL-10水平，采用 SF-36评分评估病人术后 7d生活质量，采用温哥华瘢痕评价量表( VSS)评估术后 1年、瘢痕美观度。结果两组病人手术时间和术中出血量差异无统计学意义(均 P>0.05)。治疗组住院时间［( 4.62±0.59)d比( 7.03±0.89)d］短于对照组，术后引流量［( 102.71± 12.95)mL比( 77.29±8.56)mL］明显多于对照组(均 P<0.05)。两组术前 CRP、TNF-α、IL-6、IL-1β和 IL-10差异无统计学意义(均 P>0.05)治疗组术后 1d、3d和 7d的 CRP、TNF-α、IL-6、IL-1β水平明显低于对照组(均 P<0.05)，IL-10水平明显高于对照组(均 P<0.05)。两组在喉返神经损伤、甲状旁腺损伤发生率差异无统计学意义(均 P>0.05)但治疗组术后感染、皮下淤血和积液发生率均低于对照组(均 P<0.05)。治疗组术后 7d的 SF-36评分为( 87.26±8.63)分，明显，高于对照组的( 80.43±8.03)分( t=4.10，P<0.001)。术后 1年治疗组病人 VSS评分( 3.26±0.41)分，显著低于对照组的( 4.76±0.49)分( t=.16.60，P<0.001)。结论负压创面干预可以明显减轻腔镜经胸乳入路甲状腺切除术后炎症水平，降低腔道并发症发生率，提高瘢痕美观度和生活质量，值得临床推广。 |
| 英文摘要: |
| Objective To observe the effect of negative pressure wound intervention on the level of inflammation and complicationsafter thyroidectomy through endoscopic transthoracic and breast approach.Methods A total of 100 patients with thyroid disease whounderwent thyroidectomy in Hebei Petro China Central Hospital from January 2021 to March 2022 were selected, who were assigned in-to treatment group and control group by random number table method. The treatment group received negative pressure wound treat-ment, and the control group received routine pressure dressing, with 50 cases in each group. Perioperative indexes,, pain degree (VASscore) at 1, 3 and 7 days after surgery and C-reactive protein necrosis factor-α (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1β, and IL-10 levels were compared between the two groups, and the SF-36 score was used to evaluate the quality of life 7days after surgery. The Vancouver scarscale (VSS) was used to evaluate the scar appearance 1 year after surgery.Results There were no significant differences in operation time and intraoperative blood loss between the two groups (P>0.05). The length of hospital stay in the treatment group was shorter than the control group [(4.62±0.59) d vs. (7.03±0.89) d], and the postoperative drainage volume [(102.71±12.95) mL vs. (77.29±8.56) mL] was significantly more than that in the control group (P<0.05). There were no significant dif-ferences in CRP, TNF-α, IL-6, IL-1β and IL-10 between the two groups before surgery (all P>0.05). The levels of CRP, TNF-α, IL-6 and IL-1β in the treatment group were significantly lower than the control group at 1 day, 3 days and 7 days after surgery (all P<0.05). IL-10 level was significantly higher than control group (all P<0.05). There were no significant differences in the incidences of recurrentlaryngeal nerve injury and parathyroid injury between the two groups (P>0.05), but the incidences of postoperative cutaneous infection,subcutaneous congestion and effusion in the treatment group were lower than those in the control group (P<0.05). The SF-36 score of the treatment group was (87.26±8.63) points at 7 days after surgery, which was significantly higher than the control group (80.43±8.03)points (t=4.10, P<0.001). One year after surgery, the VSS score of the treatment group was (3.26±0.41) points, which was significantly |
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