不同切口在肥胖女性甲状腺乳头状癌根治术中的应用效果比较  

Application effect of different incisions in the radical resection of papillary thyroid carcinoma in obese females:a comparative study

作　　者：王斌[1,2] 陈洪丽 马骁 WANG Bin;CHEN Hongli;MA Xiao(School of Life Science,Tiangong University,Tianjin 300387,China;The First Department of Head and Neck Surgery,Beijing South Region Oncology Hospital,Beijing 100076,China;Department of Head and Neck Surgery,Beijing Cancer Hospital,Beijing 100142,China)

机构地区：[1]天津工业大学生命科学学院,天津市300387 [2]北京南郊肿瘤医院头颈外一科,北京市100076 [3]北京大学肿瘤医院头颈外科,北京市100142

出　　处：《广西医学》2023年第17期2079-2082,共4页Guangxi Medical Journal

基　　金：北京大学肿瘤医院科学研究基金(2020自主-3)。

摘　　要：目的 比较不同切口在肥胖女性甲状腺乳头状癌(PTC)根治术中的应用效果。方法 将60例行PTC根治术的肥胖女性患者随机分为常规衣领式切口组(A组)和第二颈横纹切口组(B组),每组30例。两组患者均接受标准甲状腺癌根治术治疗,A组采用常规衣领式手术切口,B组以第二颈横纹作为手术切口。比较两组患者手术时间、术中出血量、喉上神经外侧支显露率、术后疼痛程度、美容效果满意度、术后引流量、清扫淋巴结数,记录两组患者手术并发症(喉上神经外侧支损伤、喉返神经损伤)的发生情况。结果 两组患者的手术时间、术中出血量、术后疼痛程度评分、术后引流量、淋巴结清扫个数差异无统计学意义(P>0.05),B组的喉上神经外侧支显露率、美容效果满意度优于A组(P<0.05)。A组出现1例暂时性喉返神经损伤,B组出现1例颈部肿胀,经处理后均恢复正常。结论 与衣领式切口相比,对肥胖女性患者行PTC根治术时采用第二颈横纹作为手术切口可以提高美容效果及喉上神经外侧支显露率,且并未延长手术时间及增加术中出血量,安全性较高。Objective To compare the application effect of different incisions in the radical resection of papillary thyroid carcinoma(PTC)in obese females.Methods Sixty obese female patients undergoing radical resection of PTC were randomly divided into conventional collar incision group(Group A)or second neck transverse striation incision group(Group B),with 30 cases in each group.Patients in both groups received standard radical resection of thyroid carcinoma for treatment,group A employed conventional collar incision,and group B took second neck transverse striation as surgical incision.The operation duration,intraoperative bleeding volume,exposure rate of lateral branch of superior laryngeal nerve,degree of postoperative pain,satisfaction with cosmetic effect,postoperative drainage volume,number of lymph node dissection were compared between patients of the two groups.The occurrence of operative complications(injuries to lateral branch of superior laryngeal nerve and recurrent laryngeal nerve)was recorded in patients of both groups.Results There was no statistically significant difference in operation duration,intraoperative bleeding volume,postoperative pain degree score,postoperative drainage volume,number of lymph node dissection between patients of the two groups(P>0.05).Group B exhibited superior exposure rate of lateral branch of superior laryngeal nerve and satisfaction with cosmetic effect to compare with group A(P<0.05).There was 1 case of temporary recurrent laryngeal nerve injury in group A,and 1 case of neck swelling in group B,both of which returned to normal after treatment.Conclusion Compared with collar incision,the use of the second neck transverse striation as surgical incision in the radical resection of PTC for obese female patients can improve cosmetic effect and the exposure rate of lateral branch of superior laryngeal nerve,and does not prolong operation duration,as well as dose not increase intraoperative bleeding volume,with a relatively high safety.

关 键 词：甲状腺乳头状癌 根治术 肥胖 女性 手术切口 美容效果 喉上神经外侧支 喉返神经 

分 类 号：R736.1[医药卫生—肿瘤]