Zuckerkandl结节定位喉返神经和甲状旁腺的甲状腺手术对甲状腺癌患者的术后影响

Postoperative Impact of Thyroid Surgery Through Zuckerkandl Tubercle Positioning of Recurrent Laryngeal Nerve and Parathyroid Gland on Patients with Thyroid Cancer

目的探究Zuckerkandl结节(ZT)定位喉返神经(RLN)和甲状旁腺(PTG)的甲状腺手术对甲状腺癌患者的术后影响。方法回顾性分析2018年1月—2019年6月行手术治疗的138例甲状腺癌患者的临床资料。根据手术方式不同将患者分为对照组和研究组,每组69例。对照组行常规暴露方式的甲状腺手术治疗,研究组行ZT定位RLN和PTG的甲状腺手术治疗。比较2组的围术期相关指标,术前1 d以及术后1、4、7 d的血清甲状旁腺激素(PTH)和血钙水平,并记录RLN及PRG的损伤情况。结果研究组的手术时间短于对照组(P<0.05),而2组术中出血量、淋巴结清扫数目和住院时间比较差异无统计学意义(P>0.05)。术后1、4、7 d,研究组的PTH及血钙水平高于对照组(P<0.05)。研究组RLN及PTG损伤发生率均低于对照组(P<0.05)。结论对于甲状腺癌患者,在甲状腺手术中采用ZT定位RLN和PTG,可有效识别并保护RLN和PTG,减少RLN和PTG的损伤,具有较好的应用价值。

Objective To investigate the postoperative impact of thyroid surgery through Zuckerkandl tubercle(ZT)positioning of recurrent laryngeal nerve(RLN)and parathyroid gland(PTG)on patients with thyroid cancer.Methods The clinical data of 138 patients with thyroid cancer who underwent surgery from January 2018 to June 2019 were retrospectively analyzed.Patients were divided into control group and research group according to different surgical methods,with 69 cases in each group.The control group underwent thyroid surgery with conventional exposure,and the research group underwent thyroid surgery through ZT positioning of RLN and PTG.The perioperative indexes,serum parathyroid hormone(PTH)and serum calcium levels at 1 d before operation and at 1,4,and 7 d after operation were compared between the two groups,and the injuries of RLN and PRG were recorded.Results The duration of surgery in research group was shorter than that in control group(P<0.05),while there were no differences in intraoperative blood loss,number of lymph nodes dissected and length of hospital stay between the two groups(P>0.05).At 1,4 and 7 d after surgery,the levels of PTH and blood calcium in research group were higher than those in control group(P<0.05).The incidence rate of RLN and PTG injury in research group were significantly lower than that in control group(P<0.05).Conclusion For patients with thyroid cancer,ZT positioning of RLN and PTG during thyroid surgery can effectively identify and protect the RLN and PTG,and reduce the injuries of RLN and PTG,and it has good application value.