甲状腺患侧腺叶切除术联合峡部切除术治疗分化型甲状腺癌患者的临床研究  

Clinical study of lobectomy on the affected side of the thyroid combined with isthmus resection in the treatment of differentiated thyroid carcinoma

作　　者：梁仁杰[1] 卫利民[1] 徐斌[1] LIANG Renjie;WEI Limin;XU Bin(Dept.of Oncology Surgery,the 1st Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院肿瘤外科,河南洛阳471000

出　　处：《华夏医学》2020年第6期41-45,共5页Acta Medicinae Sinica

摘　　要：目的:探讨甲状腺患侧腺叶切除术联合峡部切除术治疗分化型甲状腺癌(DTC)患者的疗效。方法:选取95例DTC患者,按治疗术式不同分为试验组(48例)和对照组(47例)。对照组采取甲状腺全切除术,试验组采取甲状腺患侧腺叶切除术联合峡部切除术。对比两组手术情况、疗效、并发症、术后1年局部复发率、远处转移率及术前、术后1d、3d血清钙、甲状旁腺激素(PTH)水平。结果:两组手术时间、住院时间、切口长度及术中出血量、总有效率及术后1年局部复发率、远处转移率比较差异无统计学意义(P>0.05);两组术后1d、3d血清钙、PTH水平较术前降低,但试验组高于对照组(P<0.05);试验组术后并发症发生率低于对照组(P<0.05)。结论:DTC患者予以甲状腺患侧腺叶切除术联合峡部切除术治疗疗效与甲状腺全切除术相当,对预后复发、转移也无不良影响,且可减轻对术后血清钙、PTH水平影响,减少并发症。Objective: To investigate the effect of lobectomy on the affected side of the thyroid combined with isthmus resection in the treatment of patients with differentiated thyroid carcinoma(DTC). Methods: 95 DTC patients were randomly divided into experimental group(n=48) and control group(n=47) according to different treatment procedures. The control group underwent total thyroidectomy, and the experimental group underwent lobectomy on the affected side of the thyroid and isthmus resection. The surgery, curative effect, complications, local recurrence rate, distant metastasis rate at 1 year after operation, and serum calcium and parathyroid hormone(PTH)levels before operation, 1 day after operation, and 3 days after operation were compared between the two groups. Results: There were no statistical differences between the two groups in operation time, hospital stay, incision length, intraoperative blood loss, total effective rate, local recurrence rate and distant metastasis rate at 1 year after surgery(P>0.05). The levels of serum calcium and PTH in both groups were lower than those before the operation on the 1 st and 3 rd day after operation, but the experimental group was higher than the control group(P<0.05). The incidence of postoperative complications in the experimental group was lower than that in the control group(P<0.05). Conclusion: In patients with DTC, the therapeutic effect of lobectomy combined with isthmus resection on the affected side of the thyroid is comparable to that of total thyroidectomy. It brings no adverse effects on the prognosis of recurrence and metastasis, and can reduce the impact on postoperative serum calcium and PTH levels and complications.

关 键 词：分化型甲状腺癌 甲状腺患侧腺叶切除术 峡部切除术 

分 类 号：R736.1[医药卫生—肿瘤]