第二颈纹切口与低领小弧形切口在甲状腺单叶全切、峡部切除联合同侧中央区淋巴结清扫术中的应用效果比较  

Application Effects of the Second Cervical Stripe Incision and Low-collar Small Arc-shaped Incision in Unilateral Thyroidectomy,Isthmectomy Combined with Ipsilateral Central Node Dissection

作　　者：张昆[1] 黄华[2] ZHANG Kun;HUANG Hua(Department of Thyroid and Breast Surgery,Nanyang Second General Hospital,Nanyang 473000,Henan Province,China;Department of Basic Medicine,Nanyang Medical College,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市第二人民医院甲状腺乳腺外科,河南南阳473000 [2]南阳医学高等专科学校基础医学部,河南南阳473000

出　　处：《罕少疾病杂志》2021年第2期16-17,共2页Journal of Rare and Uncommon Diseases

摘　　要：目的比较第二颈纹切口与低领小弧形切口在甲状腺单叶全切、峡部切除联合同侧中央区淋巴结清扫术中的应用效果。方法选取我院2017年7月至2018年10月收治的160例甲状腺癌患者,进行甲状腺单叶全切、峡部切除联合同侧中央区淋巴结清除术,A组患者采取第二颈纹切口,B组患者采取低领小弧形切口,两组各80例,比较两组手术情况和并发症的发生情况。结果B组手术时间要短于A组,差异有统计学意义(P<0.05),A组Ⅴ区淋巴清扫数要大于B组,差异有统计学意义(P<0.05),两组淋巴结清扫总数差异无统计学意义(P>0.05);A组有3例患者出现皮下积液、2名患者出现切口感染现象,经后期随访发现未出现复发者,B组有4例患者出现皮下积液现象,也未出现复发现象,两组并发症发生人数经比较差异无统计学意义(P>0.05)。结论运用第二颈纹切口或低领小弧形切口在甲状腺单叶全切、峡部切除联合同侧中央区淋巴结清扫术都能够有效治疗甲状腺癌患者,但低领小弧形切口所需手术时间更短,创口小,更有利于患者恢复,同时对术者的专业要求也更高。Objective To compare the application effects of the second cervical stripe incision and low-collar small arc-shaped incision in unilateral thyroidectomy,isthmectomy combined with ipsilateral central lymph node dissection.Methods A total of 160 patients with thyroid cancer who were admitted to the hospital between July 2017 and October 2018 were enrolled in the study.They were treated with unilateral thyroidectomy,isthmectomy combined with ipsilateral central lymph node dissection.The second cervical stripe incision and low-collar small arc-shaped incision were adopted in group A and group B,respectively,with 80 patients in each group.The situation of surgery and complications were compared between the two groups.Results The operation time of group B was shorter than that of group A(P<0.05).The number of removed lymph nodes in area V of group A was more extensive than that in group B(P<0.05).There was no significant difference in the total of removed lymph nodes between the two groups(P>0.05).There were 3 patients with subcutaneous hydrops and 2 patients with incision infection in group A.No recurrence was found during follow-up.There were 4 patients with subcutaneous hydrops in group B,and there was no recurrence,either(P>0.05).Conclusion The application of the second cervical stripe incision and low-collar small arc-shaped incision in unilateral thyroidectomy,isthmectomy combined with ipsilateral central node dissection can effectively treat patients with thyroid cancer.However,the duration of surgery with low-collar small arc-shaped incision is shorter,and the wound is smaller.It is more conducive to the recovery of patients,and the professional requirements of the surgeon are also higher.

关 键 词：淋巴结清扫术 甲状腺癌 低领切口 颈纹切口 

分 类 号：R322.25[医药卫生—人体解剖和组织胚胎学] R736.1[医药卫生—基础医学]