甲状腺系膜切除术在76例甲状腺乳头状癌患者中央区淋巴结清扫中的应用.docVIP

甲状腺系膜切除术在76例甲状腺乳头状癌患者中央区淋巴结清扫中的应用 　　[摘要] 目的 探讨甲状腺系膜切除术在甲状腺乳头状癌中央区淋巴结清扫中的临床应用效果。 方法 以南方医科大学中西医结合医院、南方医科大学南方医院2013年11月～2014年11月76例甲状腺乳头状癌患者为研究对象，回顾性分析通过甲状腺系膜切除术清扫中央区淋巴结在治疗甲状腺乳头状癌中的应用效果。 结果 76例患者行甲状腺系膜切除术清扫中央区淋巴结后均顺利度过围术期，康复出院，无窒息、甲状腺危象、切口感染、术后出血、手足抽搐及死亡等发生；2例患者术后出现声音嘶哑并发症。术后常规门诊随访，所有患者均得到随访，随访率为100%；1例患者出现右侧侵犯颈内静脉、迷走神经、颈总动脉癌结节，行二次手术，病理类型为滤泡型乳头状癌。 结论 甲状腺系膜切除术完全符合肿瘤手术淋巴结清扫整块切除的原则，能够彻底清除中央区淋巴脂肪组织，减少了甲状腺癌术后复发转移的可能性，其在甲状腺乳头状癌中央区淋巴结清扫中的应用值得推广。 　　[关键词] 甲状腺系膜切除术；甲状腺乳头状癌；中央区淋巴结清扫术 　　[中图分类号] R736.1 [文献标识码] A [文章编号] 1673-7210（2015）07（b）-0089-04 　　[Abstract] Objective To analyze the clinical effect of thyroid mesangial resection in papillary thyroid carcinoma central lymph node dissection. Methods 76 thyroid cancer patients with central lymph node dissection treatment from November 2013 to November 2014 in TCM-Integrated Hospital of Southern Medical University and Nanfang Hospital of Southern Medical University were for the study. Application results of central lymph node dissection surgery by thyroid mesangial resection in the treatment of papillary thyroid carcinoma were retrospectively analyzed. Results 76 cases of patients successfully passed through perioperative period， discharged， without asphyxia occurring， thyroid stormming， wound infection， bleeding， tetany and deaths after thyroid mesangial resection excision of central zone lymph node dissection； two cases occurred postoperative complications in a hoarse voice. After routine outpatient follow-up， all patients were followed up， the follow-up rate was 100%； one patient had violated the right of the internal jugular vein， vagus nerve， carotid artery nodules， underwent secondary surgery， histological type of follicular variant of papillary carcinoma. Conclusion Thyroid mesangial resection strictly follow the principle of en bloc resection of tumor lymph node dissection， able to remove the central area of lymphatic adipose tissue completely， reduce the possibility of thyroid cancer recurrence and metastasis， which