“六保留”功能性颈清术治疗分化型甲状腺癌  

"SIX-SPARING" NECK DISSECTION FOR DIFFERENTIATED THYROID CARCINOMA

作　　者：张林[1] 刘松岭[1] 孙国锋[1] 王海全[1] 王睿[1] 

机构地区：[1]青岛市肿瘤医院外一科,山东青岛266042

出　　处：《青岛大学医学院学报》2008年第6期508-509,512,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨“六保留”功能性颈清术治疗分化型甲状腺癌的效果及临床意义。方法1995年1月-2000年2月我科收治的诊断明确需行颈淋巴结清除术甲状腺癌病人97例,其中治疗组66例（72例次）行“六保留”功能性颈清术,即保留胸锁乳突肌、颈内静脉、副神经、耳大神经、枕小神经和颈横动、静脉;对照组31例（32例次）行功能性颈清术（三保留）,即保留胸锁乳突肌、颈内静脉、副神经。对比分析两组病人术后恢复情况及疗效。结果两组无死亡病例,治疗组病人枕部、耳部皮肤感觉在1-2月恢复正常,斜方肌功能良好。随访5-10年,两组均有1例区域淋巴结复发,分别复发于术后5年10个月和5年3个月,两组复发率差异无显著性（P〉0.05）。结论“六保留”功能性颈清术治疗分化型甲状腺癌的生存率与功能性颈清术相近,但可大大提高病人的生存质量。Objective To evaluate the value of ＂six-sparing＂ functional neck dissection for differentiated thyroid carcinoma. Methods Ninety seven patients with confirmed thyroid cancer were admitted from January 1995 to February 2000 for neck dissection. Of whom, treatment group （66 cases） were treated with six-sparing neck dissection, i.e. sternocleidomastiod muscle, internal jugular vein, accessory nerve, the great auricular nerve, lesser occipital nerve and transverse artery-vein were reserved; control group （31 cases） were treated with ＂three-sparing＂ neck dissection, the sternocleidomastiod muscle, internal jugular vein, and accessory nerve were reserved. The therapeutic efficacy and post-operative course were compared between the two groups. Results The skin sensation on occipital and aural regions recovered in one to two months after surgery. Follow-up for five to ten years showed regional lymph node recurrence, one case in each group, which occurred at five years and ten months, and five years and three months, respectively, after surgery. The difference of recurrence between the two groups was not significant （P〉 0.05）. Conclusion The survival of the ＂six-sparing＂ neck dissection for differentiated thyroid carcinoma is similar to functional neck dissection, but the former greatly improves the patients＇ quality of life.

关 键 词：甲状腺肿瘤 功能保留性颈清术 治疗结果 

分 类 号：R736.1[医药卫生—肿瘤]