中央淋巴结清扫术治疗分化型甲状腺癌的临床疗效及预后分析

Effect of central lymph node dissection on the clinical efficacy and prognosis in treating differentiated thyroid carcinoma patients

目的探讨中央淋巴结清扫术对分化型甲状腺癌临床疗效和预后生存质量影响。方法以因分化型甲状腺癌在本院进行单侧甲状腺全切和峡部及对侧的全切术且术中进行中央淋巴结清扫术的100例患者作为研究对象,对患者术后各区域淋巴结转移率进行统计,并对相关影响因素及患者预后生活质量进行观察分析。结果淋巴结的转移与年龄、肿瘤直径有相关性(P<0.05)。100例患者中央淋巴结清扫术后Ⅵ区患者的转移率最高,差异具有统计学意义(P<0.05)。1例患者患侧喉返神经被甲状腺乳头状癌变组织包围,无法暴露分离受损;4例患者术后出现皮下出血;5例出现声嘶。经过治疗已经出院,术中无死亡和气管塌陷等情况出现。患者术后生活质量评分显著高于术前(P<0.05)。结论对分化型甲状腺癌患者进行中央淋巴结清扫术可以将转移率极高的中央区淋巴结和隐匿淋巴结进行清除,在改善术后患者生活质量方面也起到了一定的作用。

Objective To investigate the effect of central lymph node dissection on the clinical efficacy and prognostic quality of life for differentiated thyroid carcinoma patients.Methods A total of 100 differentiated thyroid carcinoma patients in our hospital for unilateral thyroidectomy and isthmus,contralateral resection underwent central lymph node dissection were as research objects.The lymph node metastasis rate of the patients was statistically analyzed,and the related factors,prognostic quality of life were observed and analyzed.Results Lymph node metastasis was correlated to age and tumor diameter(P<0.05).Patients inⅥarea had the highest rate of metastasis among 100 patients with central lymph node dissection,which showed a significant difference(P<0.05).Recurrent laryngeal nerve,surrounded by thyroid papillary carcinoid tissue,was injured in 1 patient,and there were 4 cases with subcutaneous hemorrhage,5 with hoarseness.All were discharged after treatment,and there were no died and tracheal collapse patients.The quality of life score was significantly higher than preoperation(P<0.05).Conclusion Central lymph node dissection can eliminate lymph node and occult lymph nodes with high metastasis rate,and improve the quality of life of differentiated thyroid cancer patients.