颈部2个皮纹切口与传统“L”形切口颈淋巴结清扫术对机体血清创伤细胞因子的影响  

Effect of two short striae incision or traditional “L” shaped incision in neck dissection of differentiated thyroid carcinoma on serum trauma cytokines

作　　者：耿中利[1] 王薇[1] 单美慧[1] 任光辉[1] 董朝[1] 马斌林[1] 

机构地区：[1]新疆医科大学附属肿瘤医院乳腺、头颈外科,乌鲁木齐830011

出　　处：《中南大学学报（医学版）》2012年第12期1260-1264,共5页Journal of Central South University ：Medical Science

基　　金：乌鲁木齐市科学技术计划项目(Y09231001)~~

摘　　要：目的：比较颈部2个皮纹切口与传统＂L＂形切口颈淋巴结清扫术对患者机体血清创伤细胞因子白细胞介素（IL）-2,IL-6,C-反应蛋白（CRP）的影响。方法：对2008年12月至2011年7月在新疆医科大学附属肿瘤医院行保留皮神经颈淋巴结清扫术（即保留皮神经的Ⅱ,Ⅲ,Ⅳ,Ⅵ区清扫）的58例甲状腺癌患者按照患者意愿分为2组,第1组26例采用颈部2个横行皮纹小切口行颈淋巴结清扫术,第2组32例采用传统颈部＂L＂形切口行颈淋巴结清扫术,检测并比较2组所有患者的术前1 d、术后1,3,5 d血清细胞因子IL-2,IL-6,CRP的含量。结果：2个皮纹切口与＂L＂形切口术后第1天血清IL-2含量均有下降,但变化差异无统计学意义（P〉0.05）,术后第3天开始两组均恢复到术前水平;两组术后第1天血清IL-6值均升高,术后第3天均有下降,且术后第5天两组均基本恢复到术前水平;两组血清CRP含量术后第1,3天和5天均较术前明显上升,差异有统计学意义（P〈0.05）,2个切口和＂L＂形切口术前和术后组间差异无统计学意义（P〉0.05）。术后随访8~40个月未出现局部及颈部淋巴结复发。结论：颈部2个皮纹切口颈淋巴结清扫术与传统＂L＂形颈淋巴结清扫术相比,对机体血清应激细胞因子影响相当,并不增加创伤性,其在不影响颈淋巴结清扫效果的同时又兼顾了功能与美容,是甲状腺癌保留皮神经的Ⅱ,Ⅲ,Ⅳ,Ⅵ区淋巴结清扫的一种较为理想的手术入路。Objective： To compare the trauma of neck dissection on the human body between two-striae incision and traditional ＂L＂ shaped incision by serum trauma cytokines.Methods： Patients with differentiated thyroid carcinoma hospitized from December 2008 to July 2011 were divided into 2 groups according to their own will.The first group 26 patients） had two-striae incision and the second group 32 patients） had traditional ＂L＂ shaped incision.The serum level of interleukin（IL）-2,IL-6 and C-reactive protein（CRP） in all patients were examined 1 day before and 1,3 and 5 days after the surgery.Results： No statistical significance was found between the 2 groups,although level of IL-2 decreased 1 day after the surgery,but recovered to normal 3 days later.The level of IL-6 in both groups increased 1 day after the surgery,began to decrease 3 days after the surgery,and recovered to normal 5 days after the surgery.The level of CRP suggested statistical significance（P0.05）,which increased obviously 1,3 and 5 days after the surgery.No statistical difference was found before or after the surgery between the 2 groups（P0.05）.After follow-up for 8–40 months,no local recurrence or lymph node metastasis was found.Conclusion： Compared with the traditional ＂L＂ shaped incision,two-striae incision in neck dissection does not increase the serum level of trauma cytokines and trauma to human body after the surgery.Two-striae incision is an ideal surgical approach to differentiated thyroid carcinoma.

关 键 词：分化型甲状腺癌 二个皮纹切口 淋巴结清扫 血清创伤细胞因子 

分 类 号：R736.1[医药卫生—肿瘤]