甲状腺乳头状癌中央区淋巴结解剖性清扫技术的临床应用  

Clinical application of anatomical lymph node dissection in central region of papillary thyroid cancer

作　　者：张磊[1] 汤铜[1] 史加宁[1] 李佳[1] 郑璐[1] 贾文俊 张帅 李婉婉 ZHANG Lei;TANG Tong;SHI Jianing;LI Jia;ZHENG Lu;JIA Wenjun;ZHANG Shuai;LI Wanwan(Department of Thyroid and Breast Surgery,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院甲乳外科,安徽合肥230601

出　　处：《安徽医药》2021年第4期690-693,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨甲状腺乳头状癌(PTC)中央区淋巴结解剖性清扫(ADLN)技术的临床应用。方法回顾安徽医科大学第二附属医院甲乳外科2017年9月至2019年8月收治的75例PTC病人的临床资料,分析ADLN技术对于完整清扫区域淋巴组织以及保护甲状旁腺功能方面的作用。病人依据是否使用纳米碳分为常规组和纳米碳组,术中行甲状腺全/近全切除或者腺叶+峡部切除术、同时应用ADLN技术清扫单侧或双侧中央区淋巴结。结果应用ADLN技术的常规组病人单侧或双侧中央区清扫的总淋巴结数量、淋巴结转移病例数、术后第一天的血钙以及甲状旁腺激素水平均不低于纳米碳组,差异无统计学意义(P>0.05)。单侧、双侧淋巴结清扫组术后第一天的血钙水平分别为(2.14±0.12)mmol/L、(1.93±0.13)mmol/L,术后第一天的甲状旁腺激素水平分别为32.6(24.2,44.0)ng/L、3.0(3.0,11.9)ng/L,差异有统计学意义(P<0.05)。结论应用ADLN技术有利于在PTC术中彻底清扫中央区淋巴结,也有利于保护甲状旁腺功能。Objective To investigate the clinical application of anatomical lymph node dissection in the central region(ADLN)of papillary thyroid cancer.Methods The clinical data of 75 patients with papillary thyroid cancer(PTC)admitted to the Department of thyroid and breast surgery,the Second Affiliated Hospital of Anhui Medical University from September 2017 to August 2019 were reviewed.The role of ADLN in the complete dissection of regional lymph tissue and the protection of parathyroid function was analyzed.The patients were assigned into two groups according to whether to use carbon nanoparticle(CNP)or not.During the operation,total/near total thyroidectomy or lobectomy plus isthmectomy was performed,and ADLN was used to dissection unilateral or bilateral central lymph nodes.Results The total number of lymph nodes,the number of lymph node metastasis cases,the level of blood calcium and PTH on the first day after operation in the conventional group with unilateral or bilateral ADLN were not lower than those in the CNP group,and the difference was not statistically significant(P>0.05).The serum calcium levels of unilateral and bilateral lymph node dissection group on the first day after operation were(2.14±0.12)mmol/L and(1.93±0.13)mmol/L,respectively,and the parathyroid hormone levels on the first day after operation were 32.6(24.2,44.0)pg/ml and 3.0(3.0,11.9)pg/ml,respectively,with statistical significance(P<0.05).Conclusion ADLN in the operation of papillary thyroid cancer is helpful to dissection lymph nodes thoroughly and protect parathyroid function.

关 键 词：甲状腺肿瘤 颈淋巴结清扫术 纳米复合物 碳 筋膜间隙 解剖 

分 类 号：R736.1[医药卫生—肿瘤]