术中精细化被膜解剖腺叶切除在分化型甲状腺癌患者中的应用价值分析
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摘要
目的探讨术中精细化被膜解剖腺叶切除在分化型甲状腺癌患者中的应用价值。方法收集行全甲状腺切除术联合单侧中央区淋巴结清扫治疗的分化行甲状腺癌患者94例,按随机数表法分为两组,各47例。对照组行常规腺叶切除治疗,观察组予术中精细化被膜解剖腺叶切除治疗,比较两组血清甲状旁腺激素(PTH)、钙离子(Ca~(2+))浓度、手术相关指标、并发症及复发情况。结果与术前相比,两组术后PTH浓度均明显改善,且观察组高于对照组,差异有统计学意义(P<0.05);与对照组和术前相比,观察组术后血清Ca~(2+)浓度变化不大,差异无统计学意义;两组术中出血量、手术时间及淋巴清除数量比较,差异无统计学意义;观察组并发症发生率明显低于对照组,差异有统计学意义(P<0.05);观察组复发率和对照组比较,差异无统计学意义。结论术中精细化被膜解剖腺叶切除术治疗分化型甲状腺癌效果显著,可减少术中损伤喉返神经及甲状旁腺,值得临床推广。
Objective To investigate the application value of meticulous capsule dissection and thyroid lobectomy in differentiated thyroid carcinoma(DTC).Methods 94 DTC patients treated with total thyroidectomy and unilateral central lymph node dissection were selected,and they were divided into two groups by random number table,47 cases in each group.Control group was given routine thyroid lobectomy,while observation group was treated with meticulous capsule dissection and thyroid lobectomy.The parathyroid hormone(PTH),calcium ion(Ca~(2+)) concentration,surgical indexes,complications and recurrence were compared between the two groups.Results Compared with before surgery,the postoperative PTH concentration in two groups improved,and observation group was higher than control group(P<0.05); Compared with control group and before surgery,the postoperative Ca~(2+) concentration in observation group had no great changes,without statistical difference; There was no statistical difference in the intraoperative bleeding volume,operation time and amount of lymph node dissection between the two groups; The incidence of complications in observation group was lower than that in control group(P<0.05); There was no statistical difference in the recurrence rate between the two groups.Conclusion Meticulous capsule dissection and thyroid lobectomy in treatment of DTC is effective,it can reduce recurrent laryngeal nerve injury and parathyroid glands,which is worthy of clinical promotion.
Objective To investigate the application value of meticulous capsule dissection and thyroid lobectomy in differentiated thyroid carcinoma(DTC).Methods 94 DTC patients treated with total thyroidectomy and unilateral central lymph node dissection were selected,and they were divided into two groups by random number table,47 cases in each group.Control group was given routine thyroid lobectomy,while observation group was treated with meticulous capsule dissection and thyroid lobectomy.The parathyroid hormone(PTH),calcium ion(Ca~(2+)) concentration,surgical indexes,complications and recurrence were compared between the two groups.Results Compared with before surgery,the postoperative PTH concentration in two groups improved,and observation group was higher than control group(P<0.05); Compared with control group and before surgery,the postoperative Ca~(2+) concentration in observation group had no great changes,without statistical difference; There was no statistical difference in the intraoperative bleeding volume,operation time and amount of lymph node dissection between the two groups; The incidence of complications in observation group was lower than that in control group(P<0.05); There was no statistical difference in the recurrence rate between the two groups.Conclusion Meticulous capsule dissection and thyroid lobectomy in treatment of DTC is effective,it can reduce recurrent laryngeal nerve injury and parathyroid glands,which is worthy of clinical promotion.
引文
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[3]申安霞,赵薇,王怡沁,等.儿童分化型甲状腺癌手术后甲状旁腺机能减退症的观察与护理[J].中国医师杂志,2016,18(z1):179-180.
[4]金雄伟,张浩,张云生,等.分化型甲状腺癌不同外科手术的临床效果对比研究[J].当代医学,2015,21(10):101-102.
[5]王勤奋.分化型甲状腺癌诊疗研究进展[J].医学综述,2016,22(10):1910-1913.
[6]赵靖,王荣福.血清Tg水平在分化型甲状腺癌诊疗进程中的临床价值[J].肿瘤学杂志,2016,22(11):880-884.
[7]马芸,焦泽龙,卢灿荣.分化型甲状腺癌患者在不同手术方式后喉返神经损伤及术后低钙血症的临床研究[J].医学综述,2016,22(8):1662-1664.
[8]郭勇.腔镜辅助甲状腺切除手术对分化型甲状腺癌患者的疗效及预后分析[J].中华临床医师杂志,2016,10(9):1271-1274.