甲状腺癌颈部淋巴结清扫术后肺部改变及发热的诊治经验  

Experience in diagnosis and treatment of pulmonary changes and fever after extensive radical surgery for thyroid cancer

作　　者：梁青壮 李朋[1] 徐露[2] 易辛[1] 韦伟[1] LIANG Qingzhuang;LI Peng;XU Lu(Department of Thyroid Gland Surgery,Peking Universily Shenzhen Hospital,Guangdong,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院甲状腺乳腺外科,518036 [2]北京大学深圳医院影像科,518036

出　　处：《临床外科杂志》2021年第1期68-70,共3页Journal of Clinical Surgery

基　　金：深圳市三名工程资助项目(SZSM201612010);深圳市医学重点学科建设经费资助项目。

摘　　要：目的分析甲状腺癌颈部淋巴结清扫术后肺部改变及发热的相关因素。方法甲状腺癌颈部淋巴结清扫手术病人46例,分析性别、年龄、抽烟史、体质量指数(BMI)、手术方式等因素对术后肺部改变及发热的影响。结果左侧颈部清扫10例,右侧颈部清扫24例,双侧颈部清扫12例,不同清扫方式术后的病人肺部改变发生率比较,差异有统计学意义(P<0.05);术后肺部改变阳性8例,其中4例术后发热(50%),肺部改变阴性38例,其中1例出现术后发热(2.6%)。是否肺部改变术后发热发生率比较,差异有统计学意义(P<0.05);偏廋4例,体重正常25例,超重13例,肥胖4例;不同身体质量指数病人的肺部改变发生率比较,差异无统计学意义(P>0.05),但术后发热发生率比较,差异有统计学意义(P<0.05)。结论甲状腺癌双侧颈部淋巴结清扫术后比单侧颈部淋巴结清扫术后更容易出现肺部改变,而发生肺部改变的病人更容易术后发热。偏廋或者肥胖的病人更容易出现肺部改变及术后发热。Objective To analyze the related factors of pulmonary changes and fever after cervical lymph node dissection for thyroid cancer.Methods A total of 46 patients with thyroid cancer undergoing cervical lymph node dissection were collected.The effects of gender,age,smoking history,body mass index(BMI),surgical method and other factors on postoperative pulmonary changes and fever were analyzed statistically.Results There were 10 cases of left neck dissection,24 cases of right neck dissection,and 12 cases of bilateral neck dissection.There was statistical significance in the incidence of lung changes among patients with different dissection methods(P<0.05).Postoperative pulmonary changes were positive in 8 patients,including 4 patients with postoperative fever(50%),and negative in 38 patients,including 1 patient with postoperative fever(2.6%).There was statistically significant difference in the incidence of postoperative fever(P<0.05).There were 4 cases of thinness,25 cases of normal weight,13 cases of overweight and 4 cases of obesity.There was no statistically significant difference in the incidence of lung changes among patients with different body mass indexes(P>0.05),but there was statistically significant difference in the incidence of postoperative fever(P<0.05).Conclusion Lung changes are more likely to occur after bilateral cervical lymph node dissection than after unilateral cervical lymph node dissection for thyroid cancer,and patients with lung changes are more likely to have postoperative fever.Patients who are lean or obese are more prone to pulmonary changes and postoperative fever.

关 键 词：甲状腺癌 颈部淋巴结清扫术 肺部改变 发热 

分 类 号：R736.1[医药卫生—肿瘤]