中央区淋巴结清扫在分化型甲状腺癌治疗中的作用

Effect of central lymph node dissection in differentiated thyroid cancer treatment

目的:研究中央区淋巴结清扫在分化型甲状腺癌治疗中的作用。方法:术前或术中病理确诊为分化型甲状腺癌患者86例,行甲状腺全切或患侧全切和峡部及对侧近全切除术,同时给予患者颈中区淋巴结清扫术。结果:出现颈部淋巴结转移53例(61.63%),中央区淋巴结转移50例(58.14%)。年龄<45岁的患者与≥45岁的患者进行比较,中央区淋巴结转移率较高(P<0.05);微小癌与非微小癌患者进行比较,中央区淋巴结转移率较高(P<0.05)。12例患者出现肢体或面部麻木,其中1例出现抽搐,4例出现声音嘶哑,并发症发生率18.60%,经过治疗或停药后,症状均得到缓解。结论:中央区淋巴结的清扫可以将隐匿性淋巴结转移清除,能够准确地进行病理分期并给予手术后治疗的指导。

Objective:To study the effect of central lymph node dissection in differentiated thyroid cancer treatment.Methods:86patients with preoperative or intraoperative pathological diagnosis of differentiated thyroid carcinoma were selected.They were given surgical approach to total thyroidectomy or total removal of the ipsilateral and contralateral isthmus and near total resection,while giving the patient neck lymph node dissection.Results:53 patients had lymph node metastasis(61.63%);50 patients had central lymph node metastasis(58.14%).Age<45 years and ≥45 year-old patient patients were compared,and central lymph node metastasis rate was higher(P<0.05);non-small and micro-carcinoma cancer patients were compared,and central lymph node metastasis rate was higher(P<0.05),central lymph node metastasis rate and sex, single bilateral lesions.12 cases of patients with limb or facial numbness,convulsions in 1 patient;4 patients hoarseness,complication rate was 18.60%,patients after treatment or withdrawal the symptoms were alleviated.Conclusion:Lymph node dissection central zone of occult lymph node metastases can be cleared.It can accurately be staging and giving treatment of post-operative guidance.