左侧及右侧中央区淋巴结清扫在甲状腺乳头状癌术中的应用  

Left and Right Central Lymph Node Dissection in the Operation of Papillary Thyroid Carcinoma

作　　者：范雪峰 王伦锋 余招焱[2] 欧阳建 FAN Xue-feng;WANG Lun-feng;YU Zhao-yan;OUYANG Jian(Department of General Surgery,Shuigang General Hospital,Liupanshui 553000,Guizhou,China;Department of Vascular and Thyroid Surgery,Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]首钢水钢总医院普外科,贵州六盘水553000 [2]贵州省人民医院血管甲状腺外科,贵州贵阳550002

出　　处：《医学信息》2021年第9期5-7,共3页Journal of Medical Information

基　　金：六盘水市科技计划项目(编号:52020-2020-0-2-26)。

摘　　要：目的探讨甲状腺乳头状癌(PTC)术中施行左侧中央区淋巴结清扫术(L-CLND)与右侧中央区淋巴结清扫术(R-CLND)术的差异。方法回顾性分析2017年6月~2020年5月在首钢水钢总医院初次诊治的138例PTC术中需行单侧CLND患者的临床资料,根据施行中央区淋巴结清扫术(CLND)位置不同分为L-CLND组73例与R-CLND组65例。L-CLND组施行左侧CLND术,R-CLND组施行右侧CLND术,比较两组术后淋巴结清扫数量,淋巴结阳性率及手术并发症发生情况。结果两组淋巴结转移阳性率、TT术后24 h引流量比较,差异无统计学差异(P>0.05)。R-CLND组清扫获得平均淋巴结数量多于L-CLND组、LT术后24 h引流量少于L-CLND组、术后住院天数短于L-CLND组,差异有统计学意义(P<0.05)。两组暂时性RLN损伤及甲旁减的发生率比较,差异无统计学意义(P>0.05)。结论左侧及右侧中央区淋巴结的解剖范围及毗邻结构存在一定的临床差异,实施CLND术时应有针对性地避免发生术后相关并发症。Objective To investigate the difference between the left central area lymph node dissection(L-CLND)and the right central area lymph node dissection(R-CLND)during the operation for papillary thyroid carcinoma(PTC).Methods A retrospective analysis of the clinical data of 138 patients with unilateral CLND who were diagnosed and treated in Shuigang General Hospital from June 2017 to May 2020 was retrospectively analyzed.According to the location of central lymph node dissection(CLND),they were divided into 73 cases in L-CLND group and 65 cases in R-CLND group.The left CLND operation was performed in the L-CLND group,and the right CLND operation was performed in the R-CLND group.The number of postoperative lymph node dissections,the positive rate of lymph nodes and the occurrence of surgical complications were compared between the two groups.Results There was no significant difference in the positive rate of lymph node metastasis between the two groups and the drainage volume at 24 h after TT(P>0.05).The average number of lymph nodes obtained by dissection in the R-CLND group was more than that in the L-CLND group,the drainage volume at 24 h after LT was less than that in the L-CLND group,and the postoperative hospital stay was shorter than that in the L-CLND group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of temporary RLN injury and hypoparathyroidism between the two groups(P>0.05).Conclusion There are certain clinical differences in the anatomical scope and adjacent structures of the left and right central lymph nodes.CLND should be targeted to avoid postoperative complications.

关 键 词：甲状腺乳头状癌 中央区淋巴结清扫术 甲状旁腺功能减退 

分 类 号：R736.1[医药卫生—肿瘤]