多功能保留颈清扫术治疗对分化型甲状腺癌患者围术期指标及预后的影响

The effects of multifunctional retention neck dissection on perioperative indexes and prognosis of patients with differentiated thyroid cancer

目的观察多功能保留颈清扫术治疗对分化型甲状腺癌(DIC)患者围术期指标及预后的影响。方法我院收治的伴颈部淋巴结转移的DIC患者106例,均行甲状腺全切+颈部淋巴结清扫术,其中46例行改良式颈清扫术(对照组),60例行多功能保留颈清扫术(观察组),对比两组围术期指标及预后情况。结果所有患者均顺利完成手术,两组手术时间、术中出血量、术后住院时间比较差异均无统计学意义(P>0. 05)。观察组术后面颈部肿胀发生率低于对照组(P<0. 05)。两组清扫淋巴结数目、转移度及远期复发率比较差异均无统计学意义(P>0. 05)。术后6个月,观察组皮肤感觉恢复情况优于对照组(P<0. 05)。结论多功能保留颈清扫术在不影响手术根治性的前提下,能够改善患者术后肩颈部等皮肤感觉功能,提高生活质量。

Objective To observe the effects of multifunctional neck dissection on perioperative indexes and prognosis of patients with differentiated thyroid carcinoma (DTC).Methods One hundred and six DTC patients with cervical lymph node metastasis in our hospital were treated with thyroidectomy and cervical lymph node dissection.Of the patients,46 underwent modified neck dissection (control group) and 60 patients underwent multifunctional retention neck dissection (observation group).The perioperative indexes and prognosis were compared between the two groups. Results All patients underwent successful surgery. There was no significant difference in the surgical time,intraoperative blood loss or postoperative hospital stay between the two groups (P > 0. 05). The incidence of facial and neck swelling in the observation group was significantly lower than that in the control group (P < 0. 05).There was no significant difference in the number of lymph nodes removed,degree of metastasis or long-term recurrence between the two groups (P> 0. 05).The skin sensation recovery of the observation group was significantly better than that of the control group after 6 months of surgery (P < 0. 05).Conclusion Multifunctional retention neck dissection can improve the skin sensory function of the shoulder and neck and improve the quality of life of patients without affecting the curative effect of surgery.