标题：腔镜辅助小切口与完全腔镜甲状腺切除术对患者免疫功能及生活质量的影响

      作者：陈喜志，陈润霞，蓝活    (深圳市龙岗区第七人民医院普外，广东 深圳 518114)

      卷次： 2017年28卷11期

      【摘要】 目的 探讨腔镜辅助小切口与完全腔镜甲状腺切除术对患者免疫功能及生活质量的影响。方法 选择2015年7月至2016年6月在我院行手术治疗的甲状腺疾病患者 120例为研究对象，按照随机数表法将其分为A组、B组和C组各40例，分别接受腔镜辅助小切口、完全腔镜甲状腺切除术及传统手术治疗，比较三组患者术前术后T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)及生活质量(GLQI评分)的变化。结果 术后 1 d，三组患者血清CD3+、CD4+、CD4+/CD8+均较术前明显降低，且A组、B组高于C组，A组高于B组，差异均有统计学意义(P<0.05)；术后 3 d，C组患者血清 CD3+、CD4+、CD4+/CD8+仍较术前明显降低，且低于A组、B组，差异均有统计学意义(P<0.05)；三组患者的GLQI评分均较术前明显提高，且A组、B组高于C组，A组高于B组，差异均有统计学意义(P<0.05)。结论 腔镜辅助小切口、完全腔镜甲状腺切除术与传统甲状腺手术比较，其对机体的免疫功能影响较小，且可以更加显著地改善患者的生活质量，但是腔镜辅助小切口甲状腺切除术上述作用更加明显。
      【关键词】 甲状腺疾病；腔镜辅助；完全腔镜甲状腺切除术；免疫功能；生活质量
      【中图分类号】 R653 【文献标识码】 A 【文章编号】 1003—6350（2017）11—1752—03

Effect of endoscope assisted small incision and totally endoscopic thyroidectomy on immune function and qualityof life.
CHEN Xi-zhi, CHEN Run-xia, LAN Huo. Department of General Surgery, Longgang District Seventh People'sHospital of Shenzhen, Shenzhen 518114, Guangdong, CHINA
【Abstract】 Objective To investigate the effect of endoscope assisted small incision and totally endoscopic thy-roidectomy on immune function and quality of life. Methods A total of 120 cases of patients with thyroid diseases whotreated in our hospital from July 2015 to June 2016 were selected as the research objects. According to the random num-ber table, the patients were randomly divided into group A, group B and group C, with 40 cases in each group. Theywere respectively treated with endoscope assisted small incision, totally endoscopic thyroidectomy and traditional surgi-cal. The changes of T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and quality of life (GLQI score) were com-pared among the three groups before and after operation. Results One day after operation, serum CD3+, CD4+, CD4+/CD8+ in the three groups were all significantly decreased compared with before operation, and the levels were signifi-cantly higher in group A, group B than in group C, and also in group A than group B (P<0.05). Three days after opera-tion, the serum CD3+, CD4+, CD4+/CD8+ in group C were significantly decreased compared with before operation, whichwas lower than that in group A, group B, with statistically significant difference (P<0.05). GLQI score in three groupswere significantly increased compared with before operation, and the scores were significantly higher in group A, groupB than in group C, and also in group A than group B (P<0.05). Conclusion Endoscope assisted small incision, totallyendoscopic thyroidectomy, compared with traditional thyroidectomy, have smaller impact on the body's immune func-tion, and can significantly improve the quality of life, but the endoscope assisted small incision for thyroidectomy ismore effective.
      【Key words】 Thyroid disease; Endoscope assisted; Totally endoscopic thyroidectomy; Immune function; Quality of life·论 著·doi:10.3969/j.issn.1003-6350.2017.11.011基金项目：广东省深圳市2015年度科技计划项目(编号：JYCJ20150402142648142)