摘要
目的:探讨中央区淋巴结清扫术在临床无淋巴结转移(cN0)乳头状甲状腺癌(PTC)患者中的应用。方法:选取2013年4月-2016年12月本院收治的80例cN0期PTC患者,按照随机数字表法将其分为对照组和观察组,每组40例。对照组采取甲状腺单侧腺叶+峡部切除术,观察组在对照组的基础上予以中央淋巴结清扫术。比较两组患者的围手术期情况(手术时间、引流时间、住院时间和术中出血量)和并发症发生情况,持续随访3年,记录患者甲状腺乳头状癌复发和淋巴结转移情况。结果:两组引流时间、住院时间比较,差异均无统计学意义(P>0.05);对照组的手术时间、术中出血量均显著少于观察组,差异均有统计学意义(P<0.05)。术后1个月内,观察组并发症发生率为45.00%,明显高于对照组的22.50%,差异有统计学意义(P<0.05)。术后随访3年,观察组的乳头状癌复发率和颈侧淋巴结转移率均低于对照组,但两组比较,差异均无统计学意义(P>0.05)。结论:cN0期PTC患者行中央区淋巴结清扫术后可在一定程度上减少乳头状癌复发率和颈侧淋巴结转移率,但暂时性并发症较多,且复发率和转移率与甲状腺单侧腺叶+峡部切除术无差异,建议cN0期PTC患者根据自身实际情况,谨慎选择是否行中央区淋巴结清扫术。
Objective:To explore the application of central lymph node dissection in patients with clinical non-metastatic lymph node (cN0) papillary thyroid carcinoma (PTC).Method:A total of 80 patients with stage cN0 PTC admitted to our hospital from April 2013 to December 2016 were selected.According to the random number table method,they were divided into control group and observation group,with 40 cases in each group.The control group was treated with unilateral thyroidectomy and isthmic resection,the observation group received central lymph node dissection on the basis of the control group.Perioperative conditions (operation time,drainage time,length of stay and intraoperative blood loss) and complications were compared between the two groups.The patients were followed up for 3 years to record the recurrence of thyroid papillary carcinoma and lymph node metastasis.Result:Comparison of drainage time and hospitalization time between the two groups,the differences were not statistically significant (P>0.05).The operative time and intraoperative blood loss in the control group were significantly less than those in the observation group,with statistically significant differences (P<0.05).Within 1 month after the operation,the complication rate of the observation group was 45.00%,which was significantly higher than 22.50% of the control group,the difference was statistically significant (P<0.05).After 3 years of follow-up,the recurrence rate of papillary carcinoma and the rate of cervical lymph node metastasis in the observation group were lower than those in the control group,but the differences between the two groups were not statistically significant (P>0.05).Conclusion:Patients with cN0 PTC line cleaning the postoperative lymph node in central region can be in a certain extent,reduce the papillary carcinoma recurrence rate and their neck lymph node metastasis rate,but temporary complications is more,and the rate of recurrence and metastasis and unilateral thyroid gland leaf + spondylolysis resection is no difference,suggest that patients with cN0 PTC according to their own actual situation,careful choice whether lymph node in central region are performed.
作者
刘世强
叶钿均
LIU Shiqiang;YE Dianjun(The Second People’s Hospital of Foshan City,Foshan 528000,China;不详)
出处
《中国医学创新》
CAS
2020年第14期17-20,共4页
Medical Innovation of China
基金
广东省佛山市医学类科技攻关项目(2015AB00371)。
关键词
中央淋巴结清扫术
临床无淋巴结转移
乳头状甲状腺癌
复发
并发症
Central lymph node dissection
Clinical non-metastatic lymph node
Papillary thyroid carcinoma
Recurrence
Complications
