胸锁乳突肌外侧径路在甲状腺癌侧颈部淋巴结清扫中的应用

Sternocleidomastoid lateral path in the application of the thyroid cancer lateral neck lymph node cleaning

目的探讨胸锁乳突肌外侧径路在甲状腺癌侧颈部淋巴结清扫中的应用价值。方法侧颈部淋巴结清扫中采用胸锁乳突肌外侧径路组(实验组)甲状腺癌患者40例,侧颈部淋巴结清扫中采用传统手术方式(对照组)40例,比较两组患者清扫范围达标率、手术时间、并发症的发生率。结果实验组患者在手术中均能达到根治的目的,术野显露更加清楚,Ⅱ、Ⅲ、Ⅳ、Ⅴ区淋巴结清扫数目(32枚,58枚,50枚,35枚)均高于传统手术组(17枚,35枚,33枚,20枚)。实验组手术时间平均(30.0±1.20)分钟,对照组为(45.0±3.10)分钟,实验组手术时间明显缩短,两组患者近、远期并发症总体发生率比较,差异有统计学意义(P<0.05)。结论胸锁乳突肌外侧径路在甲状腺癌侧颈部淋巴结清扫中可以达到根治的目的,可提高Ⅱ、Ⅲ、Ⅳ、Ⅴ区淋巴结清扫数目,缩短手术时间,降低近、远期并发症发生率。

Objective To explore the the application of sternocleidomastoid lateral path for thyroid cancer surgery lateral neck lymph node cleaning.Methods 40 patients with thyroid carcinoma were detected in the lateral neck lymph node cleaning using sternocleidomastoid lateral path（experimental group）and 40 cases of patients with thyroid cancer in the lateral neck lymph node cleaning cleaning scope with traditional operation method（control group）,comparing with success rates,operation time,quality of life and incidence of complications.Results Experimental group can achieve the purpose of curing in the operation,operation field showed more clearly,the lymph node zone Ⅱ,Ⅲ,Ⅳ,Ⅴ number （32,58,50,35）were higher than traditional surgery group（17,35,33,20）.Experimental group can significantly shorten the operation time[（30.0±1.20）min vs（45.0±3.10）min].The difference of incidence of near and forward future overall complications was statistically significant between the two group（P〈0.05）.Conclusion Sternocleidomastoid lateral path in thyroid carcinoma in the lateral neck lymph node cleaning can achieve the purpose of curing,significantly improve the lymph node zone Ⅱ,Ⅲ,Ⅳ,Ⅴ,shorten the operation time,reduce the recent and long-term complications and improve patient＇s quality of life.