CAJ | 학술논문

目的：探讨2种不同术式治疗咽癌放疗后颈淋巴结残留远期效果。方法对43例鼻咽癌放疗后颈淋巴结残留的患者，据淋巴结大小及是否单发分为2组，孤立性且直径≤3 cm者22例为 A组，行根治性颈淋巴结清扫术；其余21例均进入 B 组，行功能性颈淋巴结扫除术。结果术后病理显示，所有标本均为转移鳞状细胞癌，其中低分化31例，中分化7例，高分化5例，包膜外侵袭者30例，未见侵袭者13例。术后仅 A 组发生1例皮瓣部分坏死，2组并发症发生率比较无显著性差异（P＞0.05）。所有患者随访满5 a，2组5 a 死亡率无显著性差异。结论根治性和功能性颈淋巴结扫除术等挽救性手术，可控制或延缓病情发展，提高生活质量，延长患者生存时间；术后合理放化疗可有效提高5a生存率。
목적：탐토2충불동술식치료인암방료후경림파결잔류원기효과。방법대43례비인암방료후경림파결잔류적환자，거림파결대소급시부단발분위2조，고립성차직경≤3 cm자22례위 A조，행근치성경림파결청소술；기여21례균진입 B 조，행공능성경림파결소제술。결과술후병리현시，소유표본균위전이린상세포암，기중저분화31례，중분화7례，고분화5례，포막외침습자30례，미견침습자13례。술후부 A 조발생1례피판부분배사，2조병발증발생솔비교무현저성차이（P＞0.05）。소유환자수방만5 a，2조5 a 사망솔무현저성차이。결론근치성화공능성경림파결소제술등만구성수술，가공제혹연완병정발전，제고생활질량，연장환자생존시간；술후합리방화료가유효제고5a생존솔。
Objective It is to approach the long term effect of two different surgical procedures on residual of neck lymph node after radiotherapy in nasopharyngeal cancer. Methods 43 patients with residual of neck lymph node after radiotherapy in patients with nasopharyngeal cancer were divided into two groups according to whether the single and lymph node size,the lymph of diameter≤3 cm and isolated in 22 cases as in group A underwent radical neck dissection surgery;remaining 21 cases were included in group B underwent functional neck surgery to remove lymph nodes. Results Postoperative pathology showed that all specimens for the transfer of squamous cell carcinoma,which 31 cases with low differentiation,7 cases with moderately differentiated and 5 cases with high differentiation;30 cases of capsule invasion,not seen struck 13 cases. Group A only oc-curred in 1 case postoperatively part flap necrosis,there was no significant difference in complication rate between two groups ( P>0. 05). All patients were followed up for 5 years,there was no significant difference in 5 year mortality rate between both groups(P>0. 05). Conclusion Radical and functional analysis sweep save operation,to control or delay the disease develop-ment,improve the quality of life and prolong survival time,but reasonable postoperative radiation and chemotherapy,can ef-fectively improve the 5 -year survival rate.