30例分化型甲状腺癌保留颈丛皮神经锁骨上支功能性颈清扫术的临床体会

Clinical experiences of preservation on the supraclavicular nerve of cervical plexus in functional neck dissection in 30 cases of differentiated thyroid cancer

目的探讨分化型甲状腺癌功能性颈清扫术中保留颈丛皮神经锁骨上支的方法及临床效果。方法对我院2007年6月～2009年2月行保留颈丛皮神经锁骨上支功能性颈清扫术30例分化型甲状腺癌临床资料进行回顾性分析,并随机抽取同期行不保留颈丛皮神经锁骨上支功能性颈清扫术30例患者的临床资料,与其进行对比分析研究。结果进行改良的保留颈丛皮神经锁骨上支功能性颈清扫术的30例分化型甲状腺癌患者与不保留颈丛皮神经锁骨上传统的功能性颈清扫术相比较,患者术后颈肩部的麻木和疼痛感明显减轻,术后颈肩部感觉功能恢复良好,术后3～20个月随访观察,未见局部复发和局部淋巴结转移。结论分化型甲状腺癌保留颈丛皮神经锁骨上支的功能性颈淋巴结清扫术既不会影响治疗效果,又能明显减少患者术后并发症,提高生活质量,值得临床进行推广应用。

Objective To investigate the methods and clinical effects of functional neck dissection preserving on the supraclavicular nerve of cervical plexus in the treatment of differentiated thyroid cancer.Methods Clinial data of 30 cases of differentiated thyroid cancer from June 2007 to February 2009,whose supraclavicular nerve of cervical plexus were conserved in the functional neck dissection,were retrospectively analyzed,to compare with 30 cases Synchronization who were not conserved the nerve.Results The 30 cases conserved the supraclavicular nerve had obvious lessend sense of anesthesia and pain of neck and shoulder,and the function,recovered well,and no local reccurence and lymph node metastasis occured after 3 to 22 months′ follow-up.Conclusions It showed good therapy effects and improvement in life quality of differentiated thyroid cancer patients for functional neck dissection with preserving the supraclavicular nerve of cervical plexus.This improvement in operation is worth to popularize in clinical application.