患侧腺叶、峡部切除联合中央区淋巴结清扫术治疗单侧甲状腺肿块患者的临床效果

Clinical Effect of the Affected Lobes and Isthmus Combined with Central Lymph Node Dissection in the Treatment of Patients with Unilateral Thyroid Mass by Resection

目的 研究患侧腺叶、峡部切除联合中央区淋巴结清扫术(CND)在单侧甲状腺肿块患者治疗中的应用价值。方法 选取宝丰县人民医院2018年3月至2020年1月收治的114例单侧甲状腺肿块患者作为研究对象,根据手术方法分为对照组、研究组,每组57例患者。两组均接受CND术,对照组接受甲状腺完全切除术,研究组接受患侧腺叶、峡部切除术。对比两组围手术期指标、术前与术后7 d的血清学指标[主要包括甲状旁腺激素(PTH)、血清钙]、并发症及复发情况。结果 研究组手术时间、切口长度、住院时间短于对照组,术中出血量少于对照组(P<0.05);与术前比较,两组术后7 d的血清学指标血清钙、PTH水平均降低(P<0.05),研究组血清钙、PTH水平高于对照组(P<0.05);研究组并发症总发生率[5.45%(3/55)]低于对照组[17.86%(10/56)](P<0.05);随访1 a,研究组复发率与对照组比较,差异无统计学意义(P>0.05)。结论 患侧腺叶、峡部切除联合CND术治疗单侧甲状腺肿块患者的效果确切,可有效改善患者的手术情况,减少对患者甲状旁腺的损伤,减少并发症的发生,可提高手术的安全性。

Objective To study the application value of the affected side gland lobe and isthmus resection combined with central lymph node dissection(CND) in the treatment of patients with unilateral thyroid mass.Methods A total of 114 patients with unilateral thyroid mass admitted to Baofeng County People’s Hospital from March 2018 to January 2020 were selected as the research objects.According to surgical methods,they were divided into control group and study group,with 57 cases in each group.Patients in both groups were treated with CND,and patients in the control group were treated with complete thyroidectomy,patients in the study group were treated with affected lobes and isthmus resection.The perioperative indexes,serum indexes levels [mainly including parathyroid hormone(PTH),serum calcium] before and after 7 days of operation,the occurrence of complications,and the recurrence were compared between the two groups.Results The operation time,incision length,and hospitalization time in the study group were shorter than those in the control group,and the intraoperative blood loss was lower than that in the control group(P0.05).Conclusion The affected side gland and isthmic resection combined with CND has a definite effect in the treatment of patients with unilateral thyroid mass.It can effectively improve the operation condition,reduce the parathyroid injury,reduce the risk of complications,and has high safety.