摘要
[目的]研究甲状腺全切联合颈Ⅵ区淋巴结清扫对cN0期甲状腺乳头状癌患者的预后影响。[方法]以河南大学第一附属医院2012年2月-2013年12月诊治的120例cN0期甲状腺乳头状癌患者为研究对象,以随机抽签法将其等分为联合组与参照组。参照组予以甲状腺全切治疗,联合组采用甲状腺全切与颈Ⅵ区淋巴结清扫联用治疗。分别比较两组术后5 d、术后5个月时的PTH、血Ca2+水平,术前及术后5个月时的CD3+、CD4+、CD8+水平,术后并发症控制效果,以及术后5年局部复发率、远处转移率。[结果]术后5个月时联合组PTH、血Ca2+水平均高于参照组(P<0.05)。术后联合组CD3+、CD4+水平高于参照组,而CD8+水平低于参照组(P<0.05)。联合组与参照组在甲状旁腺损伤、饮水呛咳、声嘶、呼吸困难发生率方面比较均不明显(P>0.05)。联合组术后5年的局部复发、远处转移发生率低于参照组(P<0.05)。[结论]在甲状腺全切的基础上增用颈Ⅵ区淋巴结清扫可显著改善cN0期甲状腺乳头状癌患者PTH、血Ca2+、CD3+、CD4+、CD8+水平,同时不会增加术后并发症发生风险,有利于改善预后。
[Objective]To study the effect of total thyroidectomy combined with cervical lymph node dissection on the prognosis of patients with cN0 stage thyroid papillary carcinoma.[Methods]A retrospective analysis of 120 patients with stage cN0 papillary thyroid carcinoma who received treatment in the first affiliated hospital of Henan university from February 2012 to December 2013 was conducted.They were divided into joint group and reference group by random draw.Total thyroidectomy were given in reference group,Total thyroidectomy combined withⅥcervical lymphnode dissection were given in the joint group.PTH and Blood Ca2+levels 5 d and 5 months after surgery,CD3+,CD4+and CD8+levels before surgery and 5 months after surgery,postoperative complication control effect,local recurrence rate and distant metastasis rate 5 years after surgery were compared.[Results]PTH and Blood Ca2+levels in the joint group were higher than those in the reference group 5 months after operation(P<0.05).Postoperative CD3+and CD4+levels in the combined group were higher than those in the reference group,while CD8+levels were lower than those in the reference group(P<0.05).The incidence of parathyroid injury,cough,hoarseness and dyspnea were not significant differente between the combined group and the reference group(P>0.05).The incidence of local recurrence and distant metastasis 5 years after operation in the joint group was lower than that in the reference group(P<0.05).[Conclusion]Total thyroidectory with cervicalⅥarea lymph node dissection can significantly improve patients with cN0 thyroid papillary carcinoma PTH,blood Ca2+,CD3+,CD4+,CD8+level,it will not increase the risk of postoperative complications occurred at the same time,which can improve the prognosis.
作者
李帅
湛喜梅
张冠男
赵爱国
刘静
张棕帆
王文胜
LI Shuai;ZHAN Ximei;ZHANG Guangnan;ZHAO Aiguo;LIU Jing;ZHANG Zongfan;WANG Wensheng(The First Affiliated Hospital of Henan University,Kaifeng 475000,China)
出处
《河南大学学报（医学版）》
CAS
2020年第2期135-138,142,共5页
Journal of Henan University:Medical Science
