摘要
目的:探究甲状腺全切/腺叶及峡部切除联合中央区淋巴清扫对伴或不伴桥本甲状腺炎(Hashimoto thyroiditis,HT)的甲状腺乳头状癌患者的治疗效果。方法:回顾性分析漳州市第二医院2019年10月-2021年10月收治的伴HT甲状腺乳头状癌患者共计78例;另选取55例不伴HT甲状腺乳头状癌患者作为非HT组。统计两组接受甲状腺全切/腺叶及峡部切除联合中央区淋巴清扫手术时间、术中出血量、平均淋巴清扫数、总住院时间、术前及术后3 d的血钙(Ca^(2+))、甲状旁腺素(PTH)、C反应蛋白(CRP)水平,以及术后并发症发生率,并进行比较。结果:伴HT组手术时间显著长于非HT组,术中出血量多于非HT组,差异有统计学意义(P<0.05);两组平均淋巴清扫数量、总住院时间比较差异无统计学意义(P>0.05);术后3 d,两组Ca^(2+)、PTH水平均降低(P<0.05),伴HT组Ca^(2+)低于非HT组(P<0.05),而组间PTH水平比较差异无统计学意义(P>0.05);两组术后3 d CRP水平均升高(P<0.05),但组间CRP比较差异无统计学意义(P>0.05);两组术后并发症发生率差异无统计学意义(P>0.05)。结论:伴HT甲状腺乳头状癌患者进行甲状腺全切/腺叶及峡部切除联合中央区淋巴清扫的手术时间相比不伴HT患者更长,术中出血量更多,但治疗效果及术后并发症发生率并无显著差异。
Objective:To explore the therapeutic effect of total thyroidectomy/lobectomy and isthmus resection combined with central lymph node dissection in patients with thyroid papillary carcinoma with or without Hashimoto thyroiditis(HT).Method:A total of 78 patients with thyroid papillary carcinoma with HT admitted to Zhangzhou Second Hospital from October 2019 to October 2021 were retrospectively analyzed.Another 55 patients without HT thyroid papillary carcinoma were selected as the non-HT group.The two groups of total thyroidectomy/lobectomy and isthmus resection combined with central lymph node dissection operation time,intraoperative blood loss,the average number of lymph node cleaning,total length of hospital stay,and blood calcium(Ca^(2+))levels,parathyroid hormone(PTH)levels,C-reactive protein(CRP)level before operation and 3 d after operation,and incidence of postoperative complications were counted and compared.Result:The operation time of HT group was significantly longer than that of non-HT group,and the intraoperative blood loss was more than that of non-HT group,and the differences were statistically significant(P<0.05).There were no significant differences in the average number of lymph node dissection and the total length of hospital stay between the two groups(P>0.05).Three days after operation,the levels of Ca^(2+)and PTH in the two groups were decreased(P<0.05),and the levels of Ca^(2+)in the HT group were lower than those in the non-HT group(P<0.05),but there was no significant difference in PTH level(P>0.05).Three days after operation,the CRP levels in both groups were increased(P<0.05),and there was no statistically significant difference between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:The operation time of patients with thyroid thyroid papillary carcinoma with HT who received total thyroidectomy/lobectomy and isthmus resection combined with central lymph node dissection is longer,and the intraoperative blood loss is more than that of patients without HT,but there is no significant difference in the treatment effect and incidence of postoperative complications.
作者
林颖祥
黄展禄
阮井勇
LIN Yingxiang;HUANG Zhanlu;RUAN Jingyong(Zhangzhou Second Hospital,Zhangzhou 363100,China;不详)
出处
《中外医学研究》
2022年第31期147-150,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
伴桥本甲状腺炎
甲状腺乳头状癌
甲状腺全切
甲状腺腺叶及峡部切除
中央区淋巴清扫
With Hashimoto thyroiditis
Thyroid papillary carcinoma
Total thyroidectomy
Lobectomy and isthmus resection
Central lymph node dissection
