摘要
目的探讨保守淋巴结清扫术在甲状腺乳头状癌中的应用效果。方法选择甲状腺乳头状癌患者140例,按随机数字表法分为治疗组和对照组,每组70例,所有患者均根据术中快速病理结果进行手术切除治疗,治疗组患者在此基础上行中央区淋巴结清扫,对照组患者未行颈淋巴结清扫,比较两组患者的各项指标。结果治疗组患者的手术时间明显高于对照组,但是术后住院时间明显少于对照组(P<0.05)。两组患者均未发生永久性的并发症,治疗组患者术后甲状旁腺功能低下、声音嘶哑、食管瘘等并发症发生率明显低于对照组(P<0.05)。两组患者术后血清25-(OH)D3水平都明显上升,与术前差异有统计学意义(P<0.05);同时,治疗组患者术后的血清25-(OH)D3水平明显高于对照组(P<0.05)。结论甲状腺乳头状癌可发生颈部淋巴结癌转移,手术切除配合中央区淋巴结清扫可有效促进患者康复,且会减少并发症的发生,作用机制可能与促进免疫功能的恢复有关。
Objective To investigate the applying effects of conservative lymphadeneetomy for the papillary thyroid carcinoma patients. Methods A total of 140 papillary thyroid carcinoma patients based on the principle of a random draw were equally divided into the treatment group and the control group, and each group has 70 patients. All patients were underwent surgical resection based on the intraoperative rapid path- ologieal findings, the treatment group were added the central lymph node dissection, and the control group were not undergo neck dissection. The indexs were compared between two groups. Results The operative time were significantly higher in the treatment group, hut the postoperative hospital stay were significantly less than that in control group （ P 〈 0. 05 ）. There was no permanent complications in two groups, and the complication rates of hypoparathyroidism, hoarseness, esophageal fistula in the treatment group were lower than that in the control group, with significant difference （P 〈 0.05 ）. The postoperative serum 25-（OH） D3 were increased significantly compared to the preoperative ones in the two groups, respectively （P 〈 0. 05）, while the postoperative serum 25-（OH） D3 in the treatment group were significantly higher than that in con- trol groups （P 〈 0. 05）. Conclusions Papillary thyroid cancer is associated with cervical lymph node me-tastasis, and surgical resection with central lymph node dissection can effectively promote the rehabilitation of patients, and it can decrease the incidence of complications. The mechanism may relate to promoteing immune function recovery.
出处
《中国肿瘤临床与康复》
2015年第7期817-820,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
佛山市医学类科技攻关项目资助(No.0006275120428014)
