甲状腺癌颈淋巴结清扫术后淋巴漏的临床特征分析  

Analysis of the clinical features of lymphatic leakage after neck dissection for thyroid carcinoma

作　　者：龚宏勋[1] 陈十燕[1] 陈贤明[1] 

机构地区：[1]解放军福州总医院耳鼻咽喉头颈外科,350025

出　　处：《中国疗养医学》2018年第12期1242-1244,共3页Chinese Journal of Convalescent Medicine

基　　金：福建省自然科学基金面上项目(2015J01405)

摘　　要：目的探讨甲状腺癌颈淋巴结清扫术后淋巴漏的临床特征。方法回顾性分析2008年7月至2018年6月某院852例甲状腺癌接受颈淋巴结清扫术患者的临床和手术资料,其中32例术后发生淋巴漏(淋巴漏组,n=32),820例术后未发生淋巴漏(无淋巴漏组,n=820)。对比两组性别、年龄、肿瘤大小、肿瘤数目、病理类型、淋巴结阳性患者所占比例、清扫部位、手术器械使用情况。结果两组性别、年龄、病理类型、淋巴结阳性患者所占比差异无统计学意义(P>0.05)。淋巴漏组肿瘤较大、肿瘤数目较多、左侧颈淋巴结清扫术较多、使用能量器械比例更高(P<0.05)。结论甲状腺癌颈淋巴结清扫术后淋巴漏的发生一方面与解剖特点有关,另一方面也与肿瘤特征和能量器械的使用存在一定关系,术中精细操作,尤其是对于危险区域的条索状结构使用丝线结扎可能有助于降低淋巴漏的发生风险。Objective To investigate the clinical features of lymphatic leakage after neck dissection for thyroid car-cinoma.Methods The clinical and surgical data of 852 patients with thyroid cancer who underwent neck dissectionina hospital from July 2008 to June 2018 were retrospectively analyzed.Among them, 32 patients had lymphatic leak-age（ =32） and 820 patients had no lymphatic leakage（ =820）.Sex, age, tumor size, tumor number, patholeogicalpattern, proportion of lymph-node-positive patients, site of dissection and use of energy instruments were compared be-tween the two groups.Results There was no significant statistical difference in gender, age and the proportion oflymph-node-positive patients between the two groups（ 〉0.05）.Lymphatic leakage group had larger tumor, more tu-mor, more left-cervical lymph node dissection and higher proportion of using energy equipment（ 〈0.05）.ConclusionThe occurrence of lymphatic leakage after cervical lymph node dissection in thyroid carcinoma was related to theanatomical characteristics on the one hand and also to the tumor characteristics and the use of energy instruments onthe other. Fine operation during operation, especially the use of thread ligation for the striated structures in dangerousareas may help to reduce the risk of lymphatic leakage.

关 键 词：甲状腺癌 颈淋巴结清扫术 淋巴漏 

分 类 号：R736.1[医药卫生—肿瘤]