Ⅵ区淋巴清扫在甲状腺癌外科手术中意义.docVIP

Ⅵ区淋巴清扫在甲状腺癌外科手术中意义[摘要] 目的:探讨甲状腺癌采用Ⅵ区淋巴清扫在外科手术中的临床意义。方法:选择2006年1月至2010年12月甲状腺癌患者资料60例,均行Ⅵ区淋巴清扫,与早期常规手术未采用Ⅵ区淋巴清扫临吉林大学白求恩医学院床结果进行回顾性分析。结果:Ⅵ区淋巴清扫术后Ⅵ区淋巴结为46例,占76.7%。14例N0期患者术后Ⅵ区淋巴结为6例阳性,阳性率为42.8%;34例N1a患者术后Ⅵ区淋巴结为29例阳性,阳性率为85.3%;12例N1b患者术后Ⅵ区阳性率为10例阳性,阳性率为83.3%。60例患者术后有6例出现并发症,出现转移的患者11例,占18.3%;在随访中患者死亡6例。对照组50例中,出现转移患者16例,占32%,两组比较有统计学意义（P0.05）。结论:甲状腺癌采用Ⅵ区淋巴清扫治疗,可降低术后并发症发生率提高手术疗效,改善患者生命质量。 [关键词] Ⅵ区淋巴清扫;甲状腺癌;外科手术 [Abstract] Objective: To explore the area of thyroid cancer, lymph node dissection using Ⅵ in surgery, the clinical significance. Methods: Select January 2006 to December 2010 data of 60 cases of thyroid cancer, lymph node dissection were performed Ⅵ area, and the clinical results were retrospectively analyzed. Results: Area Ⅵ lymph nodes after dissection of 46 cases, accounting for 76.7%. 14 patients with N0 lymph nodes of patients Ⅵ 6 cases, the positive rate was 42.8%; 34 cases Ⅵ N1a patients and 29 cases of positive lymph nodes, the positive rate was 85.3%; 12 cases positive for N1b patients Ⅵ Area Rate of 10 cases, the positive rate of 83.3%. 60 patients, 6 patients had postoperative complications, there were 11 cases of metastasis, accounting for 18.3%; in the follow-up patients 6 died. 50 patients in the control group, there were 16 cases of metastasis, accounting for 32%, the two groups was statistically significant （P 0.05）. Conclusions: Thyroid cancer dissection using Ⅵ area treatment, can reduce the incidence of postoperative complications to improve surgical treatment, improve patient quality of life. [Key word] Ⅵ District dissection; thyroid cancer; surgery 甲状腺癌在内分泌系统恶性肿瘤中较为常见,约（0.5-10）/10万的发病率,并且在近年来有逐渐上升的趋势,特别是中青年女性临床发病率更高。甲状腺癌中98%为分化型[1-2],患者在早期行手术治疗,可达75%以上的五年生存率。故早期对甲状腺癌明确诊断在治疗中极为关键。颈部淋巴结依据美国头颈学会在1991年制定的标准来区分[3],将Ⅵ区淋巴结以内脏周围淋巴结定义,也可称之为前区。包括气管周围淋巴结、甲膜淋巴结、甲状腺周围淋巴结。Ⅵ区淋巴结主要收集喉、甲状腺、下咽等器官的淋巴回流,通常在这组有4-12个淋巴结,但因其生长空间相对狭窄,处于较深位置,导致在此区域内的转移淋巴结呈缓慢增殖,在临床上较难对这一区域内的淋巴结触及,故Ⅵ区临床处理时易被遗漏。对于cN0期甲状腺癌采用Ⅵ区淋巴清扫治疗的临床效果尚存在争议,为了对此问题更深入的探讨,本次研究选择2006年1月至2010年1