甲状腺系膜切除术在老年甲状腺乳头状癌病人中央区淋巴结清扫中的应用效果  

Effect of the thyroid gland mesangium excision in central lymph node dissection of elderly with papillary thyroid carcinoma

作　　者：姜庆贺[1] 王爱芝[1] 徐彬[1] JIANG Qing-he;WANG Ai-zhi;XU Bin(Department of General Surgery,The General Hospital of Yankuang Group LTD.,Jining Shandong 272072,China)

机构地区：[1]兖矿集团有限公司总医院普通外科,山东济宁272072

出　　处：《蚌埠医学院学报》2017年第9期1180-1182,共3页Journal of Bengbu Medical College

基　　金：兖矿集团有限公司科技创新计划(副部级企业)(20140917)

摘　　要：目的:探讨甲状腺系膜切除术在老年甲状腺乳头状癌病人中央区淋巴结清扫中的效果。方法:甲状腺乳头状癌病人134例,随机分为观察组和对照组各67例,对照组行常规中央区淋巴结清扫,观察组行甲状腺系膜切除术清扫中央区淋巴结。术后观察2组淋巴结转移情况、呛咳、声带麻痹、手足麻木及血肿等并发症发生情况,测定术后甲状腺旁水平及血钙水平。结果:观察组淋巴结复发转移率为5.97%,对照组为16.42%,2组淋巴结复发转移率差异无统计学意义(P>0.05);观察组术后并发症总发生率为10.93%,对照组为22.39%,2组术后并发症发生率差异无统计学意义(P>0.05);与治疗前比较,2组治疗后甲状旁腺水平及血钙水平均显著降低(P<0.01),与观察组比较,对照组甲状旁腺水平及血钙水平下降更明显(P<0.01)。结论:甲状腺系膜切除术在甲状腺乳头状癌者中央区淋巴清扫中应用效果良好,淋巴结复发转移率低,并发症少,无明显的甲状旁腺损伤及低血钙症,值得临床推广应用。Objective:To investigate the clinical significance of thyroid gland mesangium excision in the central lymph node dissection in papillary thyroid carcinoma patients.Methods:One hundred and thirty four patients with thyroid papillary carcinoma were randomly divided into the observation group and control group(67cases each group).The control group were treated with the routine lymph node dissection,and the observation group were treated with the central lymph node dissection of thyroid gland mesangium excision.After operation,the incidence rates of the lymph node metastasis,cough,vocal cord paralysis,numbness and hematoma were observed,and the levels of thyroid hormone and serum calcium were determined in two groups.Results:The lymph node metastasis and recurrence rate in observation group and control group were5.97%and16.42%,respectively,and the difference of which was not statistically significant(P>0.05).The total incidence rate in observation group and control groups were10.93%and22.39%,respectively,and the difference of which was not statistically significant(P>0.05).Compared before treatment,the levels of serum calcium and parathyroid hormone in2groups significantly decreased after treatment(P<0.01),and compared with the observation group,the increasing degree of the serum calcium and higher parathyroid hormone levels in control group was more obviously(P<0.01).Conclusions:The application of thyroid gland mesangium excision in the central lymph node dissection in papillary thyroid carcinoma patients is good effects,low lymph node metastasis and recurrence rate,less complications,and no obvious parathyroid injury and hypocalcemia,which is worthy of application in clinic.

关 键 词：甲状腺乳头状癌 甲状腺系膜切除术 淋巴结清扫 

分 类 号：R736.1[医药卫生—肿瘤]