CAJ | 학술논문

目的：探讨中央区淋巴结清扫在甲状腺乳头状癌治疗中的临床意义.方法选取128例甲状腺乳头状癌行同侧中央区淋巴结清扫的患者作为观察对象,按照手术方式将其分为健康观察组(65例,行单侧或双侧甲状腺腺叶+峡部切除+中央区淋巴结清扫术)与对照组(63例,行单侧或双侧甲状腺腺叶+峡部切除术),随访2 a,对比两组患者的中央区食道旁淋巴结转移、外侧区淋巴结转移、复发及并发症情况.结果1)随访期间,两组均未出现死亡病例；观察组随访期内发生中央区淋巴结转移5例,转移率为7.69%；颈侧区淋巴结转移3例,转移率为4.62%；对照组随访期内发生中央区淋巴结转移11例,转移率为17.46%；颈侧区淋巴结转移7例,转移率为11.11%；对照组明显高于观察组,两组比较具有统计学意义(P<0.05).2)观察组术后并发症发生率为13.85%,对照组术后并发症发生率为15.38%,两组之间比较无统计学意义(P>0.05).结论甲状腺乳头状癌的中央区淋巴结转移率较高,行中央区食道旁淋巴结清扫治疗术后复发率与并发症发生均较低,值得在临床中推广应用.
목적：탐토중앙구림파결청소재갑상선유두상암치료중적림상의의.방법선취128례갑상선유두상암행동측중앙구림파결청소적환자작위관찰대상,안조수술방식장기분위건강관찰조(65례,행단측혹쌍측갑상선선협+협부절제+중앙구림파결청소술)여대조조(63례,행단측혹쌍측갑상선선협+협부절제술),수방2 a,대비량조환자적중앙구식도방림파결전이、외측구림파결전이、복발급병발증정황.결과1)수방기간,량조균미출현사망병례；관찰조수방기내발생중앙구림파결전이5례,전이솔위7.69%；경측구림파결전이3례,전이솔위4.62%；대조조수방기내발생중앙구림파결전이11례,전이솔위17.46%；경측구림파결전이7례,전이솔위11.11%；대조조명현고우관찰조,량조비교구유통계학의의(P<0.05).2)관찰조술후병발증발생솔위13.85%,대조조술후병발증발생솔위15.38%,량조지간비교무통계학의의(P>0.05).결론갑상선유두상암적중앙구림파결전이솔교고,행중앙구식도방림파결청소치료술후복발솔여병발증발생균교저,치득재림상중추엄응용.
Objective To explore the clinical significance of central lymph node dissection in the treatment of papillary thyroid carcinoma. Method A total of 128 patients with thyroid papillary carcinoma who underwent lymph node dissection in the ipsilateral central region were selected as the research object. The patients were divided into the observation group (65 cases,underwent unilateral or bilateral thyroid lobectomy and isthmectomy+ central lymph node dissection ) and the control group ( 63 cases, underwent unilateral or bilateral thyroid lobectomy and isthmectomy) . The metastasis of paraesophageal and lateral lymph nodes,incidence of postoperative recurrence and complications were compared between the two groups after 2-year follow-up. Results 1)During the follow-up period,there was no death case appeared in two groups. In the observation group,there were 5 cases of central lymph node metastasis with the metastatic rate of 7 . 69%, and 3 cases of with the metastatic rate of 4. 62%. In the control group,there were 11 cases of central lymph node metastasis with the rate of 17. 46%,and 7 cases of lateral neck lymph node metastasis with the rate of 11. 11%. The lymph node metastatic rates of the control group were significantly higher than that of the observation group (P<0. 05). 2) In the observation group, <br> the complications rate was 13. 85%. In the control group,the incidence rate of complications was 15. 38% . There was not statistically significant between the two groups (P>0. 05). Conclusion The metastatic rate of central lymph node in the patients with thyroid papillary carcinoma is very higher. And the rates of postoperative recurrence and complications decreased after lymph node dissection in the central paraesophageal region. Therefore, this treatment method is worth to be extended clinically.