不同手术方式对分化型甲状腺癌患者预后的影响

目的：探讨不同手术方式对分化型甲状腺癌患者临床治疗的效果及其预后的影响。方法：回顾性分析了2005.02-2012.07入住我院的60例分化型甲状腺癌患者的临床资料,采用如下三种不同的治疗方式：甲状腺切除术联合双侧中央区颈淋巴结清扫手术;保留对侧喉返神经入喉处甲状腺组织的甲状腺次全切除术联合单侧改良颈淋巴结清扫手术;保留对侧喉返神经入喉之处甲状腺组织的甲状腺次全切除手术联合双侧改良颈淋巴结清扫手术。结果：（1）上述三组患者术后,患者的甲状旁腺的功能低下之间均存在显著的统计学差异（P〈0.01）,三组喉返神经损伤的发生率之间也存在显著的统计学差异（P〈0.01）;本组60例患者均获10-172个月（平均为93.5±10.2）的随访,上述三种手术方式下患者的癌症复发率分别为77.8%、4.5%及45.0%,三组具有显著的统计学差异（P〈0.01）;生化治愈率分别为27.8%、95.5%及50.0%;平均生存时间分别为（92.3±12.5）个月、（105.8±14.5）个月及（112.3±20.9）个月。（2）三组患者术后生存质量总得分分别为（122±9）、（118±8）及（125±9）分。结论：与甲状腺切除术联合双侧中央区颈淋巴结清扫手术进行对比,保留对侧喉返神经入喉处甲状腺组织的甲状腺次全切除术联合单侧改良颈淋巴结清扫手术与保留对侧喉返神经入喉之处甲状腺组织的甲状腺次全切除手术联合双侧改良颈淋巴结清扫手术在生存时期、术后生存质量两个方面不具显著性差异。

Influences of Different Surgical Pathology on Prognosis of Differentiated Thyroid Carcinoma（DTC）

Objective： To explore the Influences of different surgical pathology on prognosis of differentiated thyroid carcinoma（DTC）.Methods： We retrospectively analyzed 60 cases of patients with DTC admitted to our hospital during 2005.02-2012.07.Three pathologies of surgery were used： subtotal thyroidectomy line thyroidectomy plus bilateral central neck lymph node dissection;contralateral recurrent laryngeal nerve Ruhou at the thyroid tissue surgery combined with unilateral modified neck dissection surgery;contralateral recurrent laryngeal nerve Ruhou of thyroid tissue subtotal thyroidectomy surgery combined with bilateral modified neck dissection surgery.Results：（1） The three groups of patients,there were statistically significant differences（P0.01） between patients with parathyroid dysfunction,there were also statistically significant difference between the three groups the incidence of recurrent laryngeal nerve injury difference（P 0.01）;60 patients in this group were followed about 10 to 172 months（mean 93.5 ± 10.2）,patients in the three surgical methods of cancer recurrence rates were 77.8%（14/18） 4.5%（1/22） and 45.0%（9/20）;biochemical cure rates were 27.8%（5/18）,95.5%（21/22） and 50.0%（10/20）,there were statistically significant differences（P0.01） among the three groups;average survival time was（92.3 ±12.5） months,（105.8 ±14.5） months and（112.3 ±20.9） a month.（2） In accordance with the evaluation criteria of quality of life in patients with postoperative quality of life of the three groups of patients with total score（122 ±9）,respectively（118 ±8） and（125 ± 9） points,the three do not have statistically significant differences（P0.05）.Conclusion： Compared with the thyroidectomy joint bilateral central neck lymph node dissection compared thyroid tissue retained at the contralateral recurrent laryngeal nerve,Ruhou subtotal thyroidectomy surgery combined with unilateral modified neck lymph node dissection and retention contralateral recurrent laryngeal nerve the throat of the Department of thyroid tissue subtotal thyroidectomy resection joint bilateral modified neck lymph node dissection surgery survival period.