分析预防性中央区淋巴结清扫治疗cN0期分化型甲状腺癌（DTC）的临床效果。

回顾性分析2022年1月至2024年5月行手术治疗的165例cN0期DTC患者资料，根据手术方法分为观察组（n=93，甲状腺腺叶切除联合预防性中央区淋巴结清扫治疗）、对照组（n=72，甲状腺腺叶切除术治疗）。采用SPSS 23.0统计学软件分析数据，围手术期指标、甲状旁腺功能等计量资料以（

观察组手术时间、术中失血量均高于对照组（P<0.05），两组患者住院时间对比差异无统计学意义（P>0.05）。术后7 d，观察组甲状旁腺激素（PTH）、血清钙、CD4⁺、CD8⁺低于对照组（P<0.05）。组间并发症总发生率对比差异无统计学意义（P>0.05）。观察组患者术后复发率低于对照组，无进展生存期长于对照组（P<0.05）。

相较于单纯甲状腺腺叶切除术，联合预防性中央区淋巴结清扫治疗cN0期DTC虽会延长手术时间、增加出血量并影响免疫功能，但不会增加并发症发生率，还降低复发率并延长患者无进展生存期。

To analyze the clinical efficacy of prophylactic central lymph node dissection for clinical node-negative (cN0) differentiated thyroid carcinoma (DTC).

The clinical data of 165 patients with cN0 DTC who received surgical treatment between January 2022 and May 2024 were retrospectively analyzed. Patients were divided into the observation group (n=93), receiving thyroid lobectomy combined with prophylactic central lymph node dissection) and the control group (n=72), receiving thyroid lobectomy alone). Statistical analysis was performed using SPSS 23.0 software. Measurement data including perioperative indicators and parathyroid gland function parameters were expressed as (mean ± standard） deviation and compared between groups via the t test. Enumeration data such as postoperative complication rates and recurrence rates were presented as [cases (%)], and intergroup comparisons were conducted with the chi-square test. The Kaplan-Meier method was applied for survival analysis, and the Log-Rank test was used to verify the validity of the survival model. A P value less than 0.05 was defined as statistically significant.

The observation group had longer operative duration and greater intraoperative blood loss than the control group (P<0.05). No significant difference in hospital stay was detected between the two groups (P>0.05). On postoperative day 7, the levels of parathyroid hormone (PTH), serum calcium, CD4⁺ and CD8⁺ lymphocytes in the observation group were lower than those in the control group (P<0.05). There was no statistically significant intergroup difference in the overall incidence of postoperative complications (P>0.05). The postoperative recurrence rate was lower and progression-free survival was longer in the observation group relative to the control group (P<0.05).

Compared with thyroid lobectomy alone, thyroid lobectomy combined with prophylactic central lymph node dissection for cN0 DTC prolongs operative time, increases intraoperative blood loss and impairs immune function. However, this combined procedure does not raise the incidence of postoperative complications, and can reduce tumor recurrence rate and extend patients' progression-free survival.