多功能保留颈清扫术与改良式颈清扫术治疗分化型甲状腺癌的临床价值  

Clinical Value of Multi-functional Neck Sparing Dissection and Modified Neck Dissection in the Treatment of Differentiated Thyroid Cancer

作　　者：李宁 韩倩 程鹏 朱思齐 段勇 LI Ning;HAN Qian;CHENG Peng(Henan People's Hospital,Zhengzhou,450000)

机构地区：[1]河南省人民医院、郑州大学人民医院,450000

出　　处：《实用癌症杂志》2022年第4期592-594,604,共4页The Practical Journal of Cancer

摘　　要：目的探讨多功能保留颈清扫术与改良式颈清扫术治疗分化型甲状腺癌的临床价值。方法选取分化型甲状腺癌患者84例,按随机数字表法分为实验组(n=42)和对照组(n=42),对照组采用改良式颈清扫术治疗,实验组采用多功能保留颈清扫术治疗。对比2组围术期情况(手术时间、术中出血量、术后6个月住院时间)、颈部淋巴结清扫数量、甲状腺功能[三碘甲状原氨酸(T3)、甲状腺素(T4)]、血清甘油三酯(Tg)、甲状腺球蛋白抗体(TgAb)水平和并发症发生情况。结果2组手术时间、术中出血量、术后住院时间对比无显著差异(P>0.05);2组Ⅱ、Ⅲ、Ⅳ、Ⅴ区淋巴结清扫数量对比无显著差异(P>0.05);术前、术后6个月2组T3、T4水平对比无显著差异(P>0.05);术前、术后6个月2组血清Tg、TgAb水平对比无显著差异(P>0.05)。实验组并发症发生率为4.76%(2/42),较对照组的19.05%(8/42)低(P<0.05)。结论采用多功能保留颈清扫术与改良式颈清扫术治疗分化型甲状腺癌的效果相近,均可完全切除癌变组织,改善甲状腺功能,但多功能保留颈清扫术并发症发生率低,可提高整体效果。Objective To analyze the clinical value of multifunctional neck sparing dissection and modified neck dissection in the treatment of differentiated thyroid cancer.Methods 84 patients with differentiated thyroid cancer were selected and randomly divided into the experimental group(n=42)and the control group(n=42).The control group was treated with modified neck dissection,and the experimental group was treated with multi-functional neck sparing dissection.The perioperative conditions(operation time,intraoperative blood loss,postoperative 6-month hospital stay),the number of neck lymph node dissection,thyroid function[triiodothyronine(T3),thyroxine(T4)],serum triglyceride(TG),thyroglobulin antibody(TGAb)levels and complications of the 2 groups were compared.Results there was no significant difference in operation time,intraoperative blood loss and postoperative hospital stay between the 2groups(P>0.05);There was no significant difference in the number of lymph node dissections in areasⅡ,Ⅲ,ⅣandⅤbetween the two groups(P>0.05);There was no significant difference in T3 and T4 levels between the 2 groups before and 6 months after operation(P>0.05);There was no significant difference in serum TG and TGAb levels between the two groups before and 6 months after operation(P>0.05);The incidence of complications in the experimental group was 4.76%(2/42),which was lower than 19.05%(8/42)in the control group(P<0.05).Conclusion The results of multi-functional neck sparing dissection and modified neck sparing dissection in the treatment of differentiated thyroid cancer are similar,which can completely remove the cancerous tissue and improve thyroid function,but the incidence of complications of multi-functional neck sparing dissection is low,which can improve the overall effect.

关 键 词：分化型甲状腺癌 多功能保留颈清扫术 改良式颈清扫术 颈部淋巴结清扫数量 甲状腺功能 

分 类 号：R736.1[医药卫生—肿瘤]