中国当代医药Issue(30)：175-179,5.
简化的功能性颈部淋巴结清除术治疗高危甲状腺乳头状癌的临床效果
Clinical effect of simplified functional cervical lymph node dissection in the treatment of papillary thyroid carcinoma with high risk of malignant development
刘志广 1尚培中 2李兴杰 2张进权 3贾志芳 2刘春格 2任成云 2韩蕊艳2
作者信息
- 1. 内蒙古自治区乌兰察布市商都县中医院外科，内蒙古商都 013450
- 2. 解放军第二五一医院普外科，河北张家口 075000
- 3. 河北省张家口市蔚县人民医院外科，河北蔚县 075700
- 折叠
摘要
Abstract
Objective To investigate clinical effect of simplified functional cervical lymph node dissection in the treat-ment of papillary thyroid carcinoma with high risk of malignant development. Methods Clinical data of 80 cases of papillary thyroid carcinoma with high risk of malignant development in our hospital from February 1994 to May 2013 were analyzed retrospectively.Functional neck dissection (FND)was performed in FND group (50 cases)from February 1994 to October 2011.Simplified functional neck dissection(SFND)was performed in SFND group(30 cases)from Novem-ber 2011 to May 2013.Patients took orally thyroxine tablets throughout their life.131I radiotherapy was applied for 6 pa-tients with infiltrating to the outside of the thyroid gland. Results Unilateral thyroidectomy,isthmus resection and oppo-site subtotal thyroidectomy were performed in 71 cases,bilateral thyroidectomy (total thyroidectomy)was used in 9 cases. Early postoperative complication occurred in 8 cases including voice hoarse,chylous fistula and symptomatic hypocal-cemia.Incidence rate of voice hoarse,chylous fistula and symptomatic hypocalcemia in FND group was 4.0%(2/50),4.0%(2/50)and 2.0%(1/50)respectively.Incidence rate of voice hoarse,chylous fistula and symptomatic hypocalcemia in SFND group was 3.3%(1/30)respectively.There was no statistical difference between FND group and SFND group(P>0.05).Du-ration of followed-up for the long-term complication was 3 months to 1 year.Incidence rate of abnormal sen-sation and movement disturbance in the affected side neck,shoulder and upper extremity,incidence rate of in-activity in FND group was 16.0%(8/50)and 14.0%(7/50).None occurred in SFND group.There was statistical difference between FND group and SFND group (P<0.05). Conclusion The standardized surgical treatment is the key point to im-prove prognosis in papillary thyroid cancer with high risk of malignant development.SFND applied in patients with pap-illary thyroid cancer with high risk of malignant development contributed to protect sensation and movement function of the affected side neck,shoulder and upper extremity,reduce tumor recurrence and metastasis.关键词
甲状腺乳头状癌/甲状腺切除术/颈部淋巴结/颈部淋巴结清除术/术后并发症Key words
Papillary thyroid carcinoma/Thyroidectomy/Cervical lymph node/Neck dissection/Postoperative complica-tion分类
医药卫生引用本文复制引用
刘志广,尚培中,李兴杰,张进权,贾志芳,刘春格,任成云,韩蕊艳..简化的功能性颈部淋巴结清除术治疗高危甲状腺乳头状癌的临床效果[J].中国当代医药,2014,(30):175-179,5.
