摘要
目的:探讨用颈侧区淋巴清扫术治疗N_(1)b期甲状腺乳头状癌的近远期疗效及安全性。方法:基于特定时间(2020年1月至2021年1月)及固定范围(绵阳市中心医院),选取N_(1)b期甲状腺乳头状癌患者44例作为研究对象。按照治疗方式的不同将其分成2组,其中A组25例患者行开放手术,B组19例患者行颈侧区淋巴结清扫术。比较两组患者的手术时间、术中出血量、术后视觉模拟评分法(VAS)评分、清扫淋巴结数目、术后并发症的发生率、病情复发的情况及美容满意度。结果:两组患者均顺利完成手术,无患者出现毗邻结构(如颈静脉、气管等)损伤、淋巴结残留的情况。A组患者的手术时间较B组患者短(P<0.05),术后48 h的VAS评分较B组患者高(P<0.05)。两组患者术中的出血量相比,差异不显著(P>0.05)。B组患者Ⅱ区的淋巴结清扫数目较A组患者多(P<0.05)。B组患者术后并发症的发生率较A组患者低(P<0.05)。B组患者的美容满意度为94.74%,较A组患者的64.00%高(P<0.05)。两组患者随访期间均未出现病情复发的情况。结论:针对N_(1)b期甲状腺乳头状癌患者,用颈侧区淋巴清扫术进行治疗的近远期疗效均较好,术后切口疼痛轻、并发症少,安全性较高,且患者的美容满意度高。
Objective:To investigate the short-term and long-term efficacy and safety of lateral neck dissection in the treatment of N_(1)b papillary thyroid carcinoma.Methods:Based on the specific time(January 2020 to January 2021)and fixed range(Mianyang Central Hospital),44 patients with N_(1)b papillary thyroid cancer were selected as the research objects.They were divided into two groups according to the different treatment methods,25 patients in group A underwent open surgery,and 19 patients in group B underwent lateral cervical lymph node dissection.The operation time,intraoperative blood loss,postoperative visual analogue scale(VAS)score,number of dissected lymph nodes,incidence of postoperative complications,disease recurrence and cosmetic satisfaction were compared between the two groups.Results:The two groups of patients successfully completed the operation,no adjacent structures(such as jugular vein,trachea,etc.)injury,lymph node residual situation.The operation time of group A was shorter than that of group B(P<0.05),and the VAS score at 48 hours after operation was higher than that of group B(P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).The number of lymph nodes dissected in zoneⅱin group B was higher than that in group A(P<0.05).The incidence of postoperative complications in group B was lower than that in group A(P<0.05).The cosmetic satisfaction of group B was 94.74%,which was higher than that of group A(64.00%)(P<0.05).There was no disease recurrence in the two groups during follow-up.Conclusion:For patients with N_(1)b papillary thyroid carcinoma,lateral neck region lymph node dissection has good short-term and long-term efficacy,mild postoperative incision pain,fewer complications,higher safety,and high cosmetic satisfaction.
作者
何欢
HE Huan(Department of General Surgery,Mianyang Central Hospital,Mianyang 621000)
