分化型甲状腺癌患者不同术式术后残癌率和颈部淋巴结转移情况

Residual Cancer Rate and Cervical Lymph Node Metastasis in Patients with Differentiated Thyroid Cancer after Different Surgical Procedures

目的探讨分化型甲状腺癌患者不同术式术后残癌率和颈部淋巴结转移情况。方法随机选取本院2014年3月至2016年10月期间收治的分化型甲状腺癌患者共67例,根据患者治疗术式的选择将其分为对照组(35例)和研究组(32例)。对照组患者接受传统甲状腺切除术,研究组患者接受腔镜下甲状腺切除术。对比两组患者术后残癌率、术后短期内喉返神经损伤及低钙血症发生率及术后2年内颈部淋巴结转移情况。结果两组患者手术均顺利进行,研究组患者术后残癌率较对照组明显更低,P<0.05;且研究组患者术后短期内喉返神经损伤及低钙血症发生率较对照组更低,P<0.05,均在术后经短期治疗后恢复。两组患者术后2年内颈部淋巴结转移发生率对比无明显统计学差异,P>0.05。结论在分化型甲状腺癌的临床治疗中传统术式与腔镜术式均具有较好的治疗效果,但后者的病灶清除效果更为显著,但两组患者术后均存在较高的颈部淋巴结转移发生率,故应在术后积极接受治疗,及时复诊,降低不良预后的发生风险。

Objective To investigate the residual cancer rate and cervical lymph node metastasis in patients with differentiated thyroid cancer after different surgical procedures.Methods A total of 67 patients with differentiated thyroid cancer admitted to our hospital from March 2014 to October 2016 were randomly selected and divided into control group(35 cases)and study group(32 cases)according to the choice of treatment methods.The control group received traditional thyroidectomy,and the study group received endoscopic thyroidectomy.The residual cancer rate,recurrent laryngeal nerve injury after operation,incidence of hypocalcemia and cervical lymph node metastasis within 2 years after operation were compared between the two groups.Results The operation of the two groups were carried out smoothly.The residual cancer rate of the study group was significantly lower than that of the control group,P<0.05;and the incidence of recurrent laryngeal nerve injury and hypocalcemia after operation in the study group was lower than that in the control group,P<0.05,which recovered after short-term treatment after operation.There was no significant difference in the incidence of cervical lymph node metastasis between the two groups within 2 years after operation,P>0.05.Conclusion In the clinical treatment of differentiated thyroid cancer,traditional operation and endoscopic surgery have good therapeutic effect,but the latter has more significant effect on lesion clearance.However,both groups of patients have a higher incidence of cervical lymph node metastasis,so we should actively receive treatment after surgery,timely follow-up,and reduce the risk of adverse prognosis.