外科理论与实践2016，Vol.21Issue(4)：312-317,6.DOI:10.16139/j.1007-9610.2016.04.010
甲状腺癌中央区淋巴结清扫和术后甲状旁腺功能减退
Central lymph node dissection in thyroid carcinoma and postoperative hypoparathyroidism
沈晓卉 1吕春晖 1陈海珍 1薛松 1丁家增 1陈曦1
作者信息
- 1. 上海交通大学医学院附属瑞金医院外科，上海 200025
- 折叠
摘要
Abstract
Objective To investigate the effect of surgical treatment in thyroid carcinoma, especially central lymph node dissection and postoperative hypoparathyroidism. Methods One hundred patients with thyroid carcinoma resection by same surgeon group were divided into 6 groups according to surgery. Twelve patients were in lobectomy group, 7 patients in total thyroidectomy group, 13 in group of lobectomy with unilateral central lymph node dissection, 32 in group of total thyroidectomy with unilateral central lymph node dissection, 24 in group of total thyroidectomy with bilateral central lymph node dissection, and 12 in group of total thyroidectomy with lymph node dissection of bilateral central and unilateral late-ral cervical region. The surgical results and morbidity including hypoparathyroidism were analyzed. Result There were 74 cases with papillary thyroid carcinoma including pN 1 36 cases (48.6%). Parathyroid hormone levels decreased significantly on postoperative day 1 in all except lobectomy group and restored to normal after 1 month of surgery. There were 41 cases (54.7%) with temporary and 4 cases (5.3%) with permanent hypoparathyroidism in 75 patients performing total thyroidec-tomy. Temporary hypoparathyroidism incidence of the patients in total thyroidectomy group was significantly more than that in lobectomy group. However, no difference was present in the incidence of permanent hypoparathyroidism between groups. With treatment of appropriate oral calcium and vitamin D, no patients had any obvious hypocalcemia symptoms. Conclusions It is certainly useful to perform central lymph node dissection for patients with papillary thyroid carcinoma. Hypoparathyroidism is found to be mostly temporary.关键词
甲状腺手术/甲状腺癌/甲状旁腺素/甲状旁腺功能减退Key words
Thyroidectomy/Thyroid carcinoma/Parathyroid hormone/Hypoparathyroidism分类
医药卫生引用本文复制引用
沈晓卉,吕春晖,陈海珍,薛松,丁家增,陈曦..甲状腺癌中央区淋巴结清扫和术后甲状旁腺功能减退[J].外科理论与实践,2016,21(4):312-317,6.
