甲状腺腺叶切除+峡部切除术治疗cN_(0)甲状腺乳头状癌的效果  

Curative Effect of Thyroid Lobectomy Combined with Isthmectomy on cN_(0) Papillary Thyroid Carcinoma

作　　者：仝文峰 TONG Wenfeng(Department of Cardiothoracic,Thyroid and Breast Surgery,Luoyang Yanshi People’s Hospital,Luoyang City,He’nan Province 471900)

机构地区：[1]河南省洛阳市偃师人民医院心胸、甲状腺乳腺外科,471900

出　　处：《医学理论与实践》2023年第15期2532-2534,2548,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨甲状腺腺叶切除+峡部切除术治疗颈部淋巴结阴性(cN_(0))甲状腺乳头状癌(PTC)的效果及对并发症、嗓音声学指标的影响。方法:选取2019年1月—2021年12月收治的80例cN_(0)-PTC患者作为研究对象,根据手术方法分为A组(n=40)和B组(n=40),A组采用甲状腺腺叶切除+峡部切除术治疗,B组采用甲状腺全切术+中央区淋巴结清扫治疗,比较两组围手术期指标[手术时间、术中出血量、切口长度、住院时间]、甲状旁腺素(PTH)、钙(Ca)水平、嗓音声学指标[平均基频(F0)、最高基频(Fhi)、基频微扰(Jitter)、振幅微扰(Shimmer)]、术后并发症以及术后复发情况。结果:A组手术时间、住院时间、术中出血量、切口长度优于B组(P<0.05);术后3d、7d, A组PTH、Ca水平高于B组(P<0.05);术后7d, A组F0、Fhi水平高于B组,Jitter、Shimmer水平低于B组(P<0.05);A组术后并发症的总发生率低于B组(P<0.05);两组术后6个月局部复发率、淋巴结转移率比较,差异无统计学意义(P>0.05)。结论:甲状腺腺叶切除+峡部切除术治疗cN_(0)甲状腺乳头状癌效果较好,可有效减少手术创伤,改善PTH和Ca水平,降低术后并发症,且对嗓音的影响较小。Objective:To explore the curative effect of thyroid lobectomy combined with isthmectomy on papillary thyroid carcinoma(PTC)of negative cervical lymph nodes(cN_(0))and its influences on complications and voice acoustic indexes.Methods:A total of 80 patients with cN_(0)-PTC were enrolled as the research objects between January 2019 and December 2021.According to different surgical methods,they were divided into group A(n=40,thyroid lobectomy combined with isthmectomy)and group B(n=40,total thyroidectomy combined with central lymph node dissection).The perioperative indexes(operation time,intraoperative blood loss,incision length,hospitalization time),levels of parathyroid hormone(PTH),calcium(Ca)and voice acoustic indexes[mean fundamental frequency(F 0),the highest fundamental frequency(F hi),fundamental frequency perturbation(Jitter),amplitude perturbation(Shimmer)],postoperative complications and recurrence were compared between the two groups.Results:The operation time,hospitalization time,intraoperative blood loss and incision length in group A were better than those in group B(P<0.05).At 3 and 7 days after surgery,levels of PTH and Ca in group A were higher than those in group B(P<0.05).At 7 days after surgery,levels of F 0 and F hi in group A were higher than those in group B,while levels of Jitter and Shimmer were lower than those in group B(P<0.05).The total incidence of postoperative complications in group A was lower than that in group B(P<0.05).At 6 months after surgery,there was no significant difference in local recurrence rate or lymph node metastasis rate between the two groups(P>0.05).Conclusion:Curative effect of thyroid lobectomy combined with isthmectomy is good on cN_(0) PTC,which can effectively reduce surgical trauma,improve levels of PTH and Ca,and reduce postoperative complications,with few effects on voice.

关 键 词：甲状腺乳头状癌 甲状腺叶切除术 颈淋巴结 

分 类 号：R736.1[医药卫生—肿瘤]