甲状腺癌“低位领”式与“L”型切口淋巴结清扫术的比较

Comparison Between Lymph Node Dissection Through Low-collar Incision and L-shaped Incision for Thyroid Cancer

目的 探讨“低位领”式淋巴结清扫术与“L”型切口淋巴结清扫术在甲状腺癌患者中的应用。方法 选取2017年4月~2020年5月信阳市中心医院收治的92例甲状腺癌患者,将其随机分为对照组和观察组,每组46例。对照组行常规“L”型切口淋巴结清扫术,观察组行“低位领”式淋巴结清扫术,比较2组手术指标、切口外观满意度、颈肩部疼痛情况、心理状况、并发症发生情况及预后情况。结果 观察组手术时间、切口长度、术中出血量、住院时间均少于对照组(P<0.05);观察组切口外观满意度93.48%,高于对照组的78.26%(P<0.05);观察组颈肩部疼痛评分、焦虑评分、抑郁评分均低于对照组(P<0.05);观察组淋巴结转移率0.00%、淋巴结复发率2.17%和对照组淋巴结转移率4.35%、淋巴结复发率2.17%,两组比较差异无统计学意义(P>0.05)。结论 对甲状腺癌患者行“低位领”式淋巴结清扫术临床效果更佳,不增加并发症,美观效果好,有利于患者恢复。

Objective To investigate the application of lymph node dissection through a low-collar incision and a L-shaped incision to treat patients with thyroid cancer.Methods Ninety-two patients with thyroid cancer who were admitted to Xinyang Central Hospital between April 2017 and May 2020 were selected.Patients were randomly divided into control group and observation group with 46 patients in each group.Patients in the control group were treated with lymph node dissection through a L-shaped incision,and those in the observation group were treated with lymph node dissection through a low-collar incision.Surgical indicators,satisfaction with incision appearance,neck and shoulder pain,psychological status,complications,and prognosis were compared between the two groups.Results The operation time,length of incision,intraoperative blood loss,and hospital stay of the observation group were shorter or less than those of the control group (P<0.05).The satisfaction rate with incision appearance in the observation group was 93.48%,higher than 78.26% in the control group (P<0.05).The observation group had lower neck and shoulder pain score,anxiety score,and depression score than that of the control group (P<0.05).The lymph node metastasis rate and lymph node recurrence rate in the observation group were 0.00% and 2.17%.Compared with those in the control group (4.35% and 2.17%),the differences were not statistically significant (P>0.05).Conclusion Lymph node dissection through a low-collar incision can achieve better clinical effects in patients with thyroid cancer,especially in terms of complications and aesthetic effects.