摘要
目的:研究甲状腺系膜切除在甲状腺癌手术中的应用效果。方法:选取2018年6月—2020年1月于我院普外科接受甲状腺癌手术的204例患者,随机分成两组,各102例,常规组行常规中央区淋巴结清扫,研究组行甲状腺系膜切除术清扫中央区淋巴结,观察两组围术期指标、短期临床疗效及远期复发、转移情况。结果:两组患者的术中出血量、术后住院时间比较差异均无统计学意义(P>0.05),与常规组比较,研究组手术时间明显延长,但清扫淋巴结数量和阳性淋巴结数量增多,差异均有统计学意义(P<0.05);两组的短期疗效等级评估结果差异无统计学意义(P>0.05),两组临床有效率比较差异无统计学意义(P>0.05);两组术后出现的喉返神经暂时损伤、喉返神经永久损伤、低钙血症、饮水呛咳等并发症比较差异均无统计学意义(P>0.05);研究组再发乳头癌概率、转移率均明显低于常规组,差异均有统计学意义(P<0.05)。结论:甲状腺癌根治术中行甲状腺系膜切除可增加淋巴结清扫数量,降低远期复发率和转移率,具有较高的安全性。
Objective:To study the effect of mesangial resection in thyroid cancer surgery.Methods:Selected 204 patients who underwent thyroid cancer surgery at the general surgery department of our hospital from June 2018 to January 2020,and randomly divided them into two groups,each with 102 cases,the routine group underwent routine central lymph node dissection,and the study group underwent mesangial resection to clean the central lymph node.The perioperative indicators,short-term clinical efficacy,and long-term recurrence and metastasis were observed in the two groups.Results:There was no significant difference in the amount of intraoperative blood loss and postoperative hospital stay between the two groups(P>0.05).Compared with the routine group,the operation time of the study group was significantly longer,but the number of dissected lymph nodes and the number of positive lymph nodes increased,the difference was statistically significant(P<0.05);the short-term efficacy grade evaluation results of the two groups were not statistically significant(P>0.05),the clinical effective rates of the two groups were not statistically significant(P>0.05);there was no significant difference in the postoperative complications of the two groups,such as temporary injury of the recurrent laryngeal nerve,permanent injury of the recurrent laryngeal nerve,hypocalcemia,and coughing from drinking water(P>0.05);the recurrence of papillary cancer rate and metastasis rate in the study group were significantly lower than those in the routine group,and the differences were statistically significant(P<0.05).Conclusion:Mesangial resection during radical thyroid cancer surgery can increase the number of lymph node dissections,reduce the long-term recurrence rate and metastasis rate,and has high safety.
作者
蔡常青
李洪春
周大为
谭观桥
CAI Changqing;LI Hongchun;ZHOU Dawei(Department of General Surgery,the Fourth People’s Hospital of Chenzhou,Chenzhou City,Hu’nan Province 423000)
出处
《医学理论与实践》
2021年第22期3873-3875,共3页
The Journal of Medical Theory and Practice
关键词
甲状腺乳头癌
甲状腺系膜切除
中央区淋巴结
复发
转移
Papillary thyroid carcinoma
Mesangial thyroid resection
Central lymph nodes
Recurrence
Metastasis
