不同颈部处理方式对全麻下早中期舌鳞状细胞癌淋巴清除及术后复发率的影响  

Effect of Different Neck Management Methods on Lymphatic Clearance and Postoperative Recurrence Rate of Early and Middle Stage Tongue Squamous Cell Carcinoma under General Anesthesia

作　　者：何海蕾[1] 胡海东 严晓东 HE Hailei;HU Haidong;YAN Xiaodong(Ganzhou People's Hospital,Jiangxi Province,Ganzhou 341000,China;不详)

机构地区：[1]江西省赣州市人民医院,江西赣州341000 [2]江西省瑞金市中医院 [3]江西省德兴市人民医院

出　　处：《中国医学创新》2023年第29期69-73,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202311917)。

摘　　要：目的:探讨肩胛舌骨上颈淋巴清扫术与舌骨上颈淋巴清扫术在全麻下对早中期舌鳞状细胞癌患者的临床疗效。方法:选取2020年10月—2021年12月赣州市人民医院收治的156例早中期舌鳞状细胞癌患者,随机将其分为对照组与研究组,各78例。对照组采取舌骨上颈淋巴清扫术治疗,研究组采取肩胛舌骨上颈淋巴清扫术治疗。比较两组淋巴清扫效果、生存质量、转阴率、转阴者复发率及治疗满意度。结果:研究组淋巴清扫总有效率显著高于对照组(P<0.05)。研究组转阴率显著高于对照组(P<0.05);研究组转阴者复发率低于对照组,差异有统计学意义(P<0.05)。治疗后6个月,两组华盛顿医科大学生存质量量表(UW-QOL)评分均较治疗前明显升高,且研究组UW-QOL评分较对照组显著高(P<0.05)。研究组治疗满意度显著高于对照组(P<0.05)。结论:与舌骨上颈淋巴清扫术相比,肩胛舌骨上颈淋巴清扫术疗效更好,且更有助于减少舌鳞状细胞癌复发率、改善生存质量及提升治疗满意度。Objective:To investigate the clinical effect of scapulohyoid neck dissection and suprahyoid neck dissection on patients with early and middle stage tongue squamous cell carcinoma under general anesthesia.Method:A total of 156 patients with early and middle stage tongue squamous cell carcinoma admitted to Ganzhou People's Hospital from October 2020 to December 2021 were selected,and randomly divided into control group and study group,with 78 cases in each group.The control group was treated with suprahyoid neck dissection,while the study group was treated with scapulohyoid neck dissection.The effect of lymph dissection,the quality of life,the rate of negative conversion,recurrence rate of negative conversion and treatment satisfaction between the two groups were compared.Result:The total effective rate of lymph dissection in the study group was significantly higher than that in the control group(P<0.05).The negative conversion rate of patients in the study group was significantly higher than that in the control group(P<0.05).The recurrence rate in the study group who turned negative was lower than that in the control group,the difference was statistically significant(P<0.05).Six months after treatment,University of Washington-quality of life(UW-QOL)scores of patients in the two groups after treatment were significantly higher than those before treatment,the UW-QOL scores in the study group was significantly higher than that in the control group(P<0.05).The treatment satisfaction of patients in the study group was higher than that in the control group(P<0.05).Conclusion:Compared with suprahyoid neck dissection,scapulohyoid neck dissection has better curative effect,and is more helpful to reduce the recurrence rate of tongue squamous cell carcinoma,improve the quality of life and improve treatment satisfaction.

关 键 词：早中期舌鳞状细胞癌 舌骨上颈清扫术 肩胛舌骨上颈淋巴清扫术 复发 生存质量 

分 类 号：R739.86[医药卫生—肿瘤]