摘要
目的对比甲状腺全切为基础的手术治疗方案在甲状腺乳头状癌患者中的应用效果。方法选择2016年4月—2018年4月该院收治的甲状腺乳头状癌且颈部淋巴结阴性的患者64例,以随机数表法将其分为研究组与对照组,每组各32例。两组患者均行甲状腺全切术,对照组术后1个月应用碘131治疗,研究组在术中采取中央区淋巴结清扫术。对比两组患者术后并发症情况,以及1年内疾病的转移率与复发率。结果研究组术后喉返神经损伤的发生率3.13%、甲状旁腺功能低下3.13%、喉上神经损伤3.13%、永久性低钙血症3.13%、一过性低钙血症3.13%与对照组6.25%、3.13%、0.00%、0.00%、3.13%对比差异无统计学意义(χ^2=0.350、0.000、1.016、1.016、0.000,P>0.05)。研究组1年内疾病的转移率0.00%与复发率0.00%均低于对照组18.75%、18.75%(χ^2=6.621、6.621,P<0.05)。结论相较于甲状腺全切术联合碘131辅助治疗,甲状腺全切术联合中央区淋巴结清扫术能够降低cN0期甲状腺乳头状癌近期复发率与转移率,且未增加术后并发症的风险,可作为可靠的治疗方案在临床推广。
Objective To compare the effect of total thyroidectomy-based surgical treatment in patients with papillary thyroid cancer.Methods 64 cases of papillary thyroid cancer with negative cervical lymph nodes were selected from April 2016 to April 2018 in the hospital.They were randomly divided into study group and control group with 32 cases in each group.Total thyroidectomy was performed in both groups.Iodine 131 was used in the control group one month after operation.Central lymph node dissection was performed in the study group.The postoperative complications,metastasis rate and recurrence rate in one year were compared between the two groups.Results There was no significant difference in the incidence of recurrent laryngeal nerve injury(3.13%),hypoparathyroidism(3.13%),superior laryngeal nerve injury(3.13%),permanent hypocalcemia(3.13%)and transient hypocalcemia(3.13%)between the two groups(χ^2=0.350,0.000,1.016,1.016,0.000,P>0.05).The metastasis rate(0.00%)and recurrence rate(0.00%)of the disease in the study group were lower than those in the control group within one year(χ^2=6.621,6.621,P<0.05).Conclusion Compared with total thyroidectomy combined with iodine 131 adjuvant therapy,total thyroidectomy combined with central lymphadenectomy can reduce the recent recurrence rate and metastasis rate of cN0 thyroid papillary carcinoma,and does not increase the risk of postoperative complications,so it can be used as a reliable treatment program in clinical promotion.
作者
孙书峰
周爱军
王洪勇
SUN Shu-feng;ZHOU Ai-jun;WANG Hong-yong(Department of Oncology,Changping District Hospital,Beijing,102200 China)
出处
《系统医学》
2020年第6期111-113,共3页
Systems Medicine
