标题:颈段喉返神经顺行解剖切除手术治疗甲状腺微小乳头状癌的效果及安全性观察
作者:南嘉玮 1,马咏逸 1,周仲鹏 2 1.咸阳市第一人民医院普外科,陕西 咸阳 712000;2.富平县中西医结合医院外科,陕西 渭南 711700
卷次:
2021年32卷4期
【摘要】 目的 探讨甲状腺微小乳头状癌(PTMC)患者应用颈段喉返神经(RLN)顺行解剖切除手术的治疗效果及安全性,为临床诊疗提供依据。方法 选取咸阳市第一人民医院 2018年 1月至 2019年 11月收治的 100例PTMC患者作为研究对象,采用随机数表法分观察组和对照组各50例。观察组患者采用RLN顺行解剖整块切除甲状腺叶和同侧中央区域淋巴结治疗,对照组患者先切除甲状腺叶再清除中央淋巴结治疗。术后比较两组患者的手术情况、并发症、术中中转发生情况和患者对手术的满意率。结果 观察组和对照组患者的手术时间[(58.13±7.12) min vs(69.79±8.26) min]、引流时间[(2.51±0.41) d vs (3.26±0.62) d]、引流量[(29.13±3.10) mL vs (42.78±3.67) mL]和出血量[(31.02±3.22) mL vs (339.45±3.61) mL]比较,观察组明显短于或少于对照组,差异均有统计学意义(P<0.05);两组患者的淋巴结清扫数量及术中手术中转率比较差异均无统计学意义(P>0.05);两组患者术后均出现淋巴结转移、甲状旁腺损伤及声音嘶哑等并发症,但并发症总发生率比较差异无统计学意义(P>0.05);观察组患者对手术的满意率为92.0%,明显高于对照组的78.0%,差异有统计学意义(P<0.05)。结论 颈段RLN顺行解剖手术用于治疗PTMC可较好的识别和保护颈段喉返神经,减少手术时间、引流量和出血量,值得在临床推广使用。
【关键词】 甲状腺微小乳头状癌;喉返神经;顺行解剖;并发症;满意率
【中图分类号】 R736.1 【文献标识码】 A 【文章编号】 1003—6350(2021)04—0464—04
Effect and safety of antegrade anatomical resection of cervical recurrent laryngeal nerve in the treatment ofpapillary thyroid microcarcinoma.
NAN Jia-wei 1, MA Yong-yi 1, ZHOU Zhong-peng 2. 1. Department of GeneralSurgery, the First People's Hospital of Xianyang City, Xianyang 712000, Shaanxi, CHINA; 2. Department of Surgery,Fuping County Integrated Chinese and Western Medicine Hospital, Weinan 711700, Shaanxi, CHINA
【Abstract】 Objective To investigate the efficacy and safety of antegrade anatomical resection of cervical recur-rent laryngeal nerve (RLN) in patients with papillary thyroid microcarcinoma (PTMC), and to provide a basis for clinicaldiagnosis and treatment. Methods A total of 100 patients with PTMC in the First People's Hospital of Xianyang Cityfrom January 2018 to November 2019 were selected as the research objects. They were randomly divided into a observa-tion group and a control group, with 50 patients in each group. The observation group was treated with RLN anterogradeanatomical resection of the whole thyroid lobes and ipsilateral central lymph nodes, while patients in the control groupwere first treated with resection of thyroid lobes and then dissection of central lymph nodes. The operation situation,
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