低位弧形切口在甲状腺癌根治术中的应用  

Application of low curved incision in radical operation for thyroid carcinoma

作　　者：刘铁成[1] 周锐[1] 钱军[1] 韩福生[1] 陈亚[1] 

机构地区：[1]蚌埠医学院第一附属医院肿瘤外科,安徽蚌埠233004

出　　处：《中华全科医学》2016年第12期2001-2003,共3页Chinese Journal of General Practice

基　　金：安徽省高等学校省级自然科学研究资助项目(KJ2015B105by)

摘　　要：目的评估低位弧形切口应用于分化型甲状腺癌功能性颈清扫术后患者的生活质量和美观的满意度。方法回顾性分析2013年2月—2016年2月蚌埠医学院第一附属医院肿瘤外科收治的56例分化型甲状腺癌患者的临床资料。均行患侧甲状腺叶＋峡部切除或双侧甲状腺叶次全或全切术，并行中央区（VI区）及同侧颈侧区（Ⅱ～Ⅴ区）淋巴结清扫术，其中30例采用低位弧形切口（低位组），26例采用传统L型切口（传统组）。通过随访，用图表比较2组患者术后的生活质量和对切口美观的满意度。结果应用低位弧形切口治疗甲状腺癌不影响颈淋巴结清扫，无手术相关的并发症发生。术后低位组患者颈肩部僵硬、紧缩、疼痛、麻木等不适主诉较少，生活质量较高（P〈0．05）。术后低位组患者对瘢痕色泽、宽度、厚度、柔软度等外观因素满意度较高，组问差异均有统计学意义（P〈0．05）。结论低位弧形切口术后疤痕较隐蔽，外观较满意，颈部功能正常，兼顾疗效、功能与美容，不失为甲状腺癌根治术切口的理想选择。Objective To evaluate the postoperative life quality and satisfaction with the appearance of low curved incision for the functional neck dissection in patients with differentiated thyroid carcinoma（DTC）. Methods The clinical data of 56 patients with DTC in our hospital between February,2013 and February ,2016 were analyzed retrospectively. The operation of hemithyroidectomy with isthmus resection, or subtotal/total thyroidectomy, followed by central lymph node （level Ⅵ ） and ipsilateral neck（ level Ⅱ -Ⅴ ） dissection, was performed in all patients. The low curved incision operation was chosen for 30 patients in the low-incision group,while conventional L-shaped incision operation was selected for 26 patients in the conventional-incision group. The postoperative life quality and appearance of low curved incision were followed up, and the efficacy was evaluated and compared between the two groups through tables and pictures. Results The low curved incision for thyroid cancer did not interfere the neck dissection, and no procedure-related complications occurred. There was lower incidence in chief complaint of stiff in the shoulder, tight, pain and numbness and relative higher life quality in the low-incision group when compared with the conventional-incision group（P 〈 0. 05 ）. The patients in the low-incision group showed a higher satisfaction with the appearance of low curved incision, such as the color, width, thickness and suppleness of scar, the difference was statistical significant between the two groups （ P 〈 0.05 ）. Conclusion The low curved incision is the ideal choice for thyroid cancer radical surgery, with a well hidden scar, satisfactory appearance and normal neck function.

关 键 词：甲状腺肿瘤 颈清扫术 切口 

分 类 号：R736.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]