甲状腺全切除术与双叶切除术对甲状腺微小癌患者血清甲状腺激素水平、预后及生活质量的影响

目的:探讨甲状腺全切除术与双叶切除术对甲状腺微小癌患者血清甲状腺激素水平、预后及生活质量的影响。方法:回顾性分析2016年2月～2018年8月期间我院收治的甲状腺微小癌患者103例的临床资料,根据手术方式的不同分为A组(n=50,双叶切除术)和B组(n=53,甲状腺全切除术),比较两组围术期指标、甲状腺激素水平、生活质量、并发症及复发情况。结果:B组术中出血量少于A组,手术时间、住院时间、切口长度短于A组(P0.05)。术后3个月,两组血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平均较术前降低,且B组低于A组(P0.05)。术后12个月,两组生活质量简表(SF-36)量表各维度评分均较术前升高,且B组高于A组(P0.05)。B组并发症发生率低于A组(P0.05);两组复发率比较差异无统计学意义(P0.05)。结论:甲状腺全切除术治疗甲状腺微小癌患者的预后与双叶切除术相当,可有效改善临床指标、生活质量和甲状腺功能,同时还可减少并发症发生率。

Effects of Total Thyroidectomy and Double Lobectomy on Serum Thyroid Hormone Level, Prognosis and Quality of Life in Patients with Thyroid Micro Carcinoma

ABSTRACT Objective: To investigate the effect of total thyroidectomy and double lobectomy on serum thyroid hormone level, prognosis and quality of life in patients with thyroid micro carcinoma. Methods: The clinical data of 103 patients with thyroid microcarcinoma in our hospital from February 2016 to August 2018 were analyzed retrospectively. According to the different operation methods, they were divided into group A (n=50, double lobectomy) and group B (n=53, total thyroidectomy). The perioperative indexes, thyroid hormone level, quality of life, complications and recurrence were compared between the two groups. Results: The intraoperative hemorrhage in group B was less than that in group A, and the operation time, hospitalization time and incision length were shorter than those in group A (P<0.05). 3 months after operation, the levels of triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3) and free thyroxine (FT4) in the two groups were lower than those before operation, and group B is lower than group A (P<0.05). 12 months after operation, the scores all dimensions of the SF-36 in the two groups were higher than before operation, and the scores in group B were higher than those in group A (P<0.05). The incidence of complications in group B was lower than that in group A (P<0.05). There was no significant difference in recurrence rate between the two groups (P>0.05). Conclusion: The prognosis of total thyroidectomy in the treatment of thyroid microcarcinoma is similar to that of double lobectomy, it can effectively improve clinical indicators, quality of life and thyroid function.