甲状腺全切除术在分化型甲状腺癌外科治疗中的应用价值  

Application Value of Total Thyroidectomy in Surgical Treatment of Differ⁃entiated Thyroid Cancer

作　　者：陈洁[1] 钱永祥[1] CHEN Jie;Qian Yongxiang(Department of Breast armor surgery,Taicang First People´s Hospital,Taicang,Jiangsu Province,215400 China)

机构地区：[1]太仓市第一人民医院甲乳外科,江苏太仓215400

出　　处：《中外医疗》2022年第31期88-91,共4页China & Foreign Medical Treatment

摘　　要：目的 分析分化型甲状腺癌患者应用甲状腺全切除术治疗的临床价值。方法 随机选取2015年1月—2021年6月在太仓市第一人民医院行手术治疗的分化型甲状腺癌患者100例,依据手术方式将患者分为对照组与研究组,每组50例。对照组患者行甲状腺单侧腺叶切除+峡部切除术治疗,研究组患者行甲状腺全切除术治疗,比较两组患者临床疗效、手术相关指标、血清钙水平、并发症发生情况及复发率。结果 研究组临床总有效率为96.00%,明显比对照组高,差异有统计学意义(χ^(2)=4.000,P<0.05)。研究组术中出血量、术后引流量、住院时间与对照组比较,差异无统计学意义(P>0.05)。研究组术后血清钙水平明显比对照组低,差异有统计学意义(P<0.05)。研究组并发症发生率稍高于对照组,但差异无统计学意义(P>0.05)。研究组复发率明显比对照组低,差异有统计学意义(P<0.05)。结论 与甲状腺单侧腺叶切除+峡部切除术治疗相比,甲状腺全切除术治疗时喉返神经损伤率有所提高,但经过对症治疗后多数可缓解,其可能与手术者操作水平、患者疾病分期等因素相关;然而从远期复发率来说优势明显,值得临床借鉴应用。Objective To analyze the clinical value of total thyroidectomy in patients with differentiated thyroid can⁃cer.Methods A total of 100 patients with differentiated thyroid cancer who underwent surgical treatment in the Ta⁃icang First People´s Hospital from January 2015 to June 2021 were randomly selected,and the patients were divided into a control group and a study group according to the surgical method,with 50 cases in each group.The patients in the control group were treated with unilateral thyroid lobectomy+isthmic resection,and the patients in the study group were treated with total thyroidectomy.The clinical efficacy,surgery-related indicators,serum calcium levels,oc⁃currence of complications and recurrence rates of the two groups were compared.Results The total clinical effective rate of the study group was 96.00%,which was significantly higher than that of the control group,and the difference was statistically significant(χ^(2)=4.000,P<0.05).There was no statistically significant difference in intraoperative blood loss,postoperative drainage,and hospital stay between the study group and the control group(P>0.05).The postopera⁃tive serum calcium level in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).The recurrence rate of the study group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with unilateral thyroid lobectomy+isthmic resection,the incidence of complications such as re⁃current laryngeal nerve injury,increased during total thyroidectomy.However,most of them can be relieved after symptomatic treatment,which may be related to factors such as the operator's level of operation and the stage of the patient's disease.However,the long-term recurrence rate has obvious advant

关 键 词：分化型甲状腺癌 甲状腺全切除术 临床疗效 并发症 复发率 

分 类 号：R736[医药卫生—肿瘤]