分化型甲状腺癌采用甲状腺全切除术与近全切除术的疗效比较研究  

Comparative study of efficacy of total thyroidectomy and near-total thyroidectomy for differentiated thyroid cancer

作　　者：谷琦琦[1] 金子 李杨森 付利军[1] GU Qi-qi;JIN Zi;LI Yang-sen;FU Li-jun(Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院甲状腺外科,郑州450052 [2]郑州大学第一附属医院手术部,郑州450052

出　　处：《医药论坛杂志》2024年第9期911-914,918,共5页Journal of Medical Forum

摘　　要：目的研究对比分化型甲状腺癌采用甲状腺全切除术及近全切除术治疗的临床效果。方法选择2019年9月—2020年4月郑州大学第一附属医院收治的82例分化型甲状腺癌患者为研究对象,按照手术方法不同分组,采用甲状腺近全切除术的41例作为对照组,采用甲状腺全切除术的41例作为研究组。对两组临床疗效进行评估,观察手术指标、喉返神经损伤及并发症发生情况,并调查生存情况。结果在临床疗效方面,研究组(97.56%)高于对照组(85.56%)(P<0.05);在手术指标方面,研究组术中失血量和手术时间分别为(84.59±14.50)mL和(106.51±23.53)min,均低于对照组的(106.32±15.20)mL和(125.51±20.43)min(P<0.05),两组住院时间比较无统计学意义(P>0.05);研究组喉返神经损伤总发生率2.44%,低于对照组的24.39%,差异有统计学意义(P<0.05);研究组并发症总发生率7.32%,高于对照组的4.88%,但差异无统计学意义(P>0.05);研究组无进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)分别为(13.20±1.33)个月及(20.22±1.31)个月,均高于对照组,差异有统计学意义(P<0.05)。结论分化型甲状腺癌患者应用甲状腺全切除术的有效性高于近全切除术,既能提高疗效、降低喉返神经损伤率,还能改善预后,适合进一步推广。Objective To explore the effectiveness of total thyroidectomy and sbutotaltotal thyroidectomy for patients with differentiated thyroid cancer.Methods From September 2019 to April 2020,82 patients with differentiated thyroid cancer in our hospital were selected as the study objects.According to different surgical methods,41 patients with near-total thyroidectomy were selected as the control group and 4l patients with total thyroidectomy were selected as the study group.The clinical effects of the two groups were evaluated,the surgical indexes,recurrent laryngeal nerve injury and complications were observed,and the survival situation was investigated.ResultsClinical efficacy of the study group(97.56%)was higher than that of the control group(85.56%),the difference in the total effective rate between two groups was significant(P<0.05).The intraoperative blood loss and operation time of the study group were(84.59±14.50)mL and(106.51±23.53)min,which were lower than those of the control group(106.32±15.20)mL and(125.51±20.43)min,and the difference in the terms of surgical indicators between two groups was significant(P<0.05).There was no significant dfference between the two groups(P>0.05).The total incidence of recurrent laryngeal nerve injury in the study group was 2.44%,which was lower than 24.39%in the control group,and as for the total incidence of recurrent laryngeal nerve injury,the difference between two groups was significant(P<0.05).The total incidence of complications in the study group was 7.32%,slightly higher than that in the control group(4.88%),but there was no significant difference in the total incidence of complications between two groups(P>0.05).PFS and OS in the study group were(13.20±1.33)months and(20.22±1.31)months,which were higher than those in the control group,and the difference in survival between two groups of patients was significant(P<0.05).Conclusion The effectiveness of total thyroidectomy in patients with differentiated thyroid cancer is higher than that of near-total resection,

关 键 词：甲状腺癌 甲状腺全切除术 喉返神经损伤 近全切除术 

分 类 号：R736.1[医药卫生—肿瘤]