摘要
目的探讨低领弧形切口功能性颈廓清术治疗甲状腺癌的优越性。方法回顾性分析南昌大学第一附属医院耳鼻咽喉头颈外科2013年5月~2016年5月收治的甲状腺乳头状癌(PTC)伴颈侧区淋巴结转移患者的临床资料。共72侧术中采用低领弧形切口行颈廓清术(Ⅱ~Ⅵ区)。统计低领弧形切口的患者平均手术时间、平均术后住院天数及颈部各区淋巴结清扫数,并通过视觉模拟标尺评分法评价患者术后感觉与美容满意度。结果甲状腺乳头状癌采用低领弧形切口行改良根治性颈廓清术,具有住院时间短、淋巴结清扫彻底性、颈部感觉功能保留良好、颈部皮肤牵拉影响小、外观满意度值高的优点。缺点是手术时间略长,但熟练掌握后可明显缩短。结论对伴有颈侧区淋巴结转移的PTC患者采用低领弧形切口手术方式,能保证手术的彻底性,控制术后并发症的发生率以及缩短住院时间,同时改善患者颈部感觉及功能,提高生活质量,增加患者满意度。
Objective To evaluate the superiority of functional neck dissection with low-transverse arc collar incision for the treatment of papillary thyroid carcinoma （PTC）. Methods Clinical data of 72 patients suffering from PTC accompanied with cervical lymph node metastasis were analyzed retrospectively. They were all diagnosed and surgically treated in our department from May 2013 to May 2016, and functional neck dissections （ Ⅱ-Ⅳ area） with low-transverse are collar incision were performed. The average operating time, postoperative hospital stay and number of lymph node resected were calculated. Visual analog scale （VAS） score method was adopted to evaluate patients＂ satisfaction with postoperative feeling and beauty. Results The low-transverse arc collar incision applied to resection of PTC and functional neck dissection had advantages of short postoperative hospital stay, complete neck dissection, well preservation of cervical sensory function with less skin traction, and high satisfaction with appearance. The disadvantage of this incision was slightly long operating time which could be overcome by skilled grasp of surgical techniques. Conclusion The application of low-transverse arc collar incision to the resection of PTC and functional neck dissection ensures the surgical thoroughness, control of the incidence of surgical complications, shortened hospital stay, and improvement of patient＇s cervical sense and function, which can enhance their quality of life and satisfaction.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2017年第6期546-549,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词
甲状腺癌
低领弧形切口
淋巴结清扫术
Thyroid carcinoma
Low-transverse incision
Lymph node dissection
