不同手术方式对cN0期甲状腺乳头状癌疗效对比分析.docVIP

不同手术方式对cN0期甲状腺乳头状癌疗效对比分析 　　[摘要] 目的：通过对cN0期甲状腺乳头状癌不同手术方式的疗效进行对比分析，以选择较合理的手术方式。方法：回顾性分析我院治疗的cN0期甲状腺乳头状癌患者120例，根据手术方式的不同分为3组。组1，患者40例，行原发灶根治性切除，同时行患侧中央区淋巴结清扫术；组2，患者40例，仅行原发灶根治性切除；组3，患者40例，行原发灶根治性切除，常规性颈部淋巴结清扫术，对比其疗效。结果：1.所观察120例患者全部生存。组1及组3中均有1例复发病例，复发率为2.5%，组2中有8例患者复发，复发率为20%。组1及组3患者的复发率与组2相比均有显著性差异（P＜0.05），组1与组3间无明显差异（P＞0.05）。2.组1患者中发现中央区淋巴结转移12例，转移率为30%。组3患者中发现中央淋巴结转移13例，转移率为32.5%，两者间无明显差异（P＞0.05）。结论：原发灶根治性切除+患侧中央区淋巴结清扫术是cN0期甲状腺乳头状癌合理的治疗方法，它不但疗效明确，而且可以改善和提高患者的生存质量。 　　[关键词] 中央区淋巴结；甲状腺乳头状癌；淋巴结清扫术 　　[中图分类号] R736.1；R761 [文献标识码]B [文章编号] 1673-7210(2011)07（b）-039-03 　　 　　Comparison of the effects of different operation modes in cN0 papillary thyroid carcinoma 　　YU Tao 　　Department of the Otolaryngology Head and Neck Surgery，Changde No.1 Peoples Hospital，Changde415003，China 　　[Abstract] Objective： To compare the effects of different operation modes in cN0 papillary thyroid carcinoma, in order to find the most reasonable way. Methods：One hundred and twenty patients with cN0 papillary thyroid carcinoma were divided into 3 groups. In group 1，central compartment neck lymph node dissection of the tumor side was routinely performed during radical thyroidectomy: in group 2，radical thyroidectomy was performed: In group 3, radical neck dissection was performed after radical thyroidectomy. Their effects were compared. Results：1.There was 1 patient recurrent in group 1 and group 3 respectively，the recurrence rate were both 2.5%, in group 2，the recurrence rate was 20%. There were significant difference between group 2 and the other two groups. 2.The incidence of central region lymph node metastasis in group 1 was 30% （12/40）: in group 3, the rate was 32.5%（13/40）. Conclusion：It is a reasonable way to perform central compartment neck lymph node dissection during radical thyroidectomy of cN0 papillary thyroid carcinoma, it is not only an effective way, but can also improve the life quality of patients. 　　[Key words] Central compartment lymph node; Papillary thyroid carcinoma; L