双侧甲状腺乳头状癌甲状腺全切同期双侧颈清扫的安全性分析

doi:10.3877/cma.j.issn.1674-3946.2018.02.022

中华普外科手术学杂志(电子版) ›› 2018, Vol. 12 ›› Issue (02) : 162 -164. doi: 10.3877/cma.j.issn.1674-3946.2018.02.022

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双侧甲状腺乳头状癌甲状腺全切同期双侧颈清扫的安全性分析

吴骥¹, 顾书成¹, 郑向欣¹, 袁牧¹, 邱兴¹, 侍孝红², 管小青¹^,^†(

)

^1. 223800　宿迁，南京鼓楼医院集团宿迁市人民医院（徐州医科大学附属宿迁医院）甲乳外科
^2. 223800　宿迁，南京鼓楼医院集团宿迁市人民医院（徐州医科大学附属宿迁医院）病理科

收稿日期:2018-01-11 出版日期:2018-02-26
通信作者: 管小青

Safety analysis of total thyroidectomy plus bilateral neck lymph nodes dissection in bilateral papillary thyroid carcinoma at the same time

Ji Wu¹, Shucheng Gu¹, Xiangxin Zheng¹, Mu Yuan¹, Xing Qiu¹, Xiaohong Shi², Xiaoqing Guan¹^,^†()

^1. Department of Thyroid and Breast Surgery, Suqian People , s Hospital of Nanjing Drum-towl Hospital Group , Suqian 223800, China
^2. Department of Pathology, Suqian People , s Hospital of Nanjing Drum-towl Hospital Group , Suqian 223800, China

Received:2018-01-11 Published:2018-02-26
Corresponding author: Xiaoqing Guan
About author:
Corresponding author: Guan Xiaoqing, Email: Guan_dr@163.com

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吴骥, 顾书成, 郑向欣, 袁牧, 邱兴, 侍孝红, 管小青. 双侧甲状腺乳头状癌甲状腺全切同期双侧颈清扫的安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2018, 12(02): 162-164.

Ji Wu, Shucheng Gu, Xiangxin Zheng, Mu Yuan, Xing Qiu, Xiaohong Shi, Xiaoqing Guan. Safety analysis of total thyroidectomy plus bilateral neck lymph nodes dissection in bilateral papillary thyroid carcinoma at the same time[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2018, 12(02): 162-164.

目的

探讨双侧甲状腺乳头状癌行甲状腺全切同期双侧颈清扫的安全性。

方法

回顾性分析两组患者的临床资料：观察组55例行甲状腺全切同期双侧颈清扫；对照组41例行一侧腺叶切除对侧腺叶近全切除，一侧颈清扫；采用SPSS18.0进行统计学分析，两组并发症发生率比较采用χ²检验，P<0.05为差异有统计学意义。

结果

两组患者均无手术相关死亡病例、无出血、无淋巴瘘，观察组手术并发症：声音嘶哑3例、手足麻木7例、饮水呛咳6例；对照组手术并发症：声音嘶哑2例、手足麻木5例、饮水呛咳5例。两组并发症均为暂时性，并发症的发生率两组比较差异均无统计学意义(P>0.05)。

结论

双侧甲状腺乳头状癌行甲状腺全切同期双侧颈清扫是安全的，要选择适当的清扫方式，术中应用喉返神经全程显露和甲状腺被膜精细解剖技术，能有效降低术后并发症。

关键词: 甲状腺肿瘤, 甲状腺切除术, 颈淋巴结清扫术

Objective

To explore the safty of total thyroidectomy plus bilateral neck lymph nodes dissection in bilateral papillary thyroid carcinoma at the same time.

Methods

The clinical data of two groups of cases with bilateral papillary thyroid carcinoma treated in our hospital were retrospective analyzed. The observation group was 55 cases who received total thyroidectomy plus bilateral neck lymph nodes dissection at the same time. The control group was 41 cases who received one side of thyroidectomy and the other side of subtotal thyroidectomy plus one side of neck dissection. All the clinical data were statistically analyzed by SPSS 18.0 software. The operative complications of the two groups were compared with chi-square.

Results

No operative death, postoperative hemorrhage and lymphorrhagia was found in the two groups. 3 cases of hoarseness, 7 cases of numbness of hands and feet, 6 cases of choking cough were found in the observation group. 2 cases of hoarseness, 5 cases of numbness of hands and feet, 5 cases of choking cough were found in the control group. All the complications were transient. There were no statistically significant differences between the two groups (P>0.05).

Conclusions

For the cases of bilateral papillary thyroid carcinoma, total thyroidectomy plus bilateral neck lymph nodes dissection at the same time is safe. The appropriate neck lymph nodes dissection must be selected. The application of whole process of the recurrent laryngeal nerve and the careful dissection of the thyroid capsule can effectively reduce the surgical complications.

Key words: Thyroid Neoplasms, Thyroidectomy, Neck Dissection

表1 96例双侧甲状腺乳头状癌不同手术方法术后并发症发生率比较[%(例)]

组别	例数	声音嘶哑	手足麻木	饮水呛咳
观察组	55	5.45(3/55)	12.72(7/55)	10.90(6/55)
对照组	41	4.88(2/41)	12.19(5/41)	12.19(5/41)
χ²值	?	0.015	0.006	0.038
P值	?	0.902	0.938	0.845

表1 96例双侧甲状腺乳头状癌不同手术方法术后并发症发生率比较[%(例)]

组别	例数	声音嘶哑	手足麻木	饮水呛咳
观察组	55	5.45(3/55)	12.72(7/55)	10.90(6/55)
对照组	41	4.88(2/41)	12.19(5/41)	12.19(5/41)
χ²值	?	0.015	0.006	0.038
P值	?	0.902	0.938	0.845

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