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不同术式治疗甲状腺乳头状癌患者的临床疗效比较

Comparison of the clinical effects of different operative methods in the treatment of patients with papillary thyroid carcinoma

摘要:

目的 探讨不同术式治疗甲状腺乳头状癌的临床疗效.方法 将95例患者采用随机数字表法分为观察组(n=48)和对照组(n=47).对照组给予患侧腺叶+峡部切除+患侧中央区淋巴结清扫术,观察组患者给予全甲状腺切除+患侧中央区淋巴结清扫术.观察比较两组肿瘤大小、淋巴结受累情况、KPS评分、手术并发症及术后复发、转移率.结果 两组肿瘤的大小、淋巴结受累情况及手术并发症差异均无统计学意义(t=-1.367,P=0.175;t=-1.495,P=0.138;x2=1.642,P=0.232).治疗后观察组KPS评分有效率为81.25%,高于对照组的72.34%(Z=-3.639,P=0.000).观察组无复发患者,对照组复发5例,两组差异有统计学意义(x2=5.390,P=0.006).观察组1例患者发生转移,少于对照组的7例,两组差异有统计学意义(x2=5.053,P=0.031).结论 全甲状腺切除+患侧中央区淋巴结清扫术治疗PTC临床疗效显著,可有效减少肿瘤复发、转移风险,提高患者生活质量,值得推广应用.

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abstracts:

Objective To explore the clinical effect of different operative methods in the treatment of papillary thyroid carcinoma.Methods Using random number method according to the proportion of 1∶1,95 patients with papillary thyroid carcinoma were divided into observation group(n=48) and control group(n=47).The control group was treated by ipsilateral lobectomy and isthmus resection and ipsilateral central lymph node dissection,the observation group was treated by total thyroidectomy plus ipsilateral central lymph node dissection.The tumor size,lymph node involvement,the score of KPS,the surgical complications and the rate of postoperative recurrence and metastasis of the two groups were compared.Results The tumor size,lymph node involvement and surgical complications in the observation group had no statistically significant differences compared with the control group(t=-1.367,P=0.175;t=-1.495,P=0.138;x2=1.642,P=0.232).After treatment,the effective rate of KPS score in the observation group was 81.25%,which was higher than 72.34% in the control group(Z=-3.639,P=0.000).The observation group had no recurrence,which was lower than 5 cases in the control group,the difference between the two groups was statistically significant(x2=5.390,P=0.006).The observation group found 1 case of metastatic patient,which was lower than 7 cases in the control group,the difference between the two groups was statistically significant(x2=5.053,P=0.031).Conclusion Total thyroidectomy plus ipsilateral central lymph node dissection in the treatment of papillary thyroid carcinoma has significant clinical curative effect.It can effectively reduce the risk of tumor recurrence and metastasis and improve the quality of life of patients.It is worthy of popularization and application.

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