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目的 探讨腔镜微创外科手术治疗甲状腺肿瘤的效果及对患者血清白细胞介素6(IL-6)、皮质醇(Cor)和去甲肾上腺素(NE)的影响.方法 选择2016年1月至2019年1月温州天宁医院收治的甲状腺肿瘤患者82例为研究对象,采用随机数字表法分为腔镜组41例与传统组41例.传统组实施传统甲状腺手术,腔镜组实施腔镜微创外科手术.比较两组手术指标和术后并发症发生情况,术后24h、48 h疼痛情况,及术前和术后24h血清IL-6、Cor和NE水平变化.结果 腔镜组术中出血量[(25.46 ±7.82) mL]、术后引流量[(73.24±13.25)mL]均少于传统组[(53.21±9.97) mL和(107.38±16.52) mL];切口长度[(3.04±0.45) cm]小于传统组[(7.18±0.76)cm];手术时间[(67.84±15.46) min]短于传统组[(98.73±25.31) min](t=14.023、10.323、30.014、6.669,均P＜0.05).腔镜组术后并发症发生率(4.88％)低于传统组(26.83％)(x2=7.405,P＜0.05).腔镜组视觉模拟评分法(VAS)评分术后24 h[(3.64 ±0.82)分]和48 h[(2.53±0.57)分]均低于传统组[(5.37±1.29)分和(3.70 ±0.81)分](t=7.247、7.564,均P＜0.05).两组术后24 h血清IL-6、Cor和NE水平均较术前升高(均P＜0.05);腔镜组术后24h血清IL-6[(49.98±10.21)ng/L]、Cor[(125.63±17.68) ng/mL]、NE[(167.86±13.42) ng/L]均低于传统组[(83.25±14.62)ng/L、(167.51±25.47) ng/mL和(209.81±17.86) ng/L](t=11.947、8.649、12.024,均P＜0.05).结论 腔镜微创外科手术治疗甲状腺肿瘤效果明显,对应激反应影响小,且可减轻疼痛,减少术后并发症.“,”Objective To investigate the effect of endoscopic minimally invasive surgery on thyroid tumors,and its influence on serum interleukin-6 (IL-6),cortisol (Cor) and norepinephrine (NE).Methods Eighty-two patients with thyroid tumors admitted to Tianning Hospital of Wenzhou from January 2016 to January 2019 were randomly divided into laparoscopic group (41 cases) and traditional group (41 cases) according to the digital table.Traditional thyroidectomy was performed in the traditional group,and laparoscopic minimally invasive surgery was performed in the laparoscopic group.The operative indicators and complications,pain at 24 and 48 hours after operation,and serum levels of IL-6,Cor and NE before and after operation were compared between the two groups.Results The amount of bleeding during operation [(25.46 ±7.82)mL] and the amount of drainage after operation[(73.24 ± 13.25) mL] in the laparoscopic group were less than those in the traditional group [(53.21 ± 9.97) mL and (107.38 ± 16.52)mL],the length of incision [(3.04 ± 0.45) cm] in the laparoscopic group was shorter than that in traditional group [(7.18 ±0.76) cm],and the operation time [(67.84 ± 15.46) min] in the laparoscopic group was shorter than that in traditional group [(98.73 ±25.31) min],the differences were statistically significant(t =14.023,10.323,30.014,6.669,all P ＜ 0.05).The incidence of postoperative complications in the laparoscopic group (4.88 ％) was lower than that in the traditional group (26.83 ％) (x2 =7.405,P ＜ 0.05).The VAS scores of the laparoscopic group at 24h [(3.64 ±0.82) points] and 48h [(2.53 ±0.57) points] after operation were lower than those of the traditional group [(5.37 ± 1.29) points and (3.70 ± 0.81) points] (t =7.247,7.564,all P ＜0.05).The serum levels of IL-6,Cor and NE in the two groups at 24 hours after operation were higher than those before operation (all P ＜ 0.05).The serum levels of IL-6 [(49.98 ± 10.21) ng/L],Cor [(125.63 ±17.68)ng/mL] and NE [(167.86 ± 13.42) ng/L] in the laparoscopic group 24 hours after operation were lower than those in the traditional group [(83.25 ± 14.62) ng/L,(167.51 ± 25.47)ng/mL and (209.81 ± 17.86) ng/L](t =11.947,8.649,12.024,all P ＜ 0.05).Conclusion Endoscopic minimally invasive surgery is effective in the treatment of thyroid neoplasms,which has little effect on stress response and can relieve pain and reduce postoperative complications.