术前高频彩超指导分化型甲状腺癌淋巴结清扫的应用

发布时间：2018-06-22 09:19

本文选题：分化型甲状腺癌 + 淋巴结清扫　；参考：《中国医疗设备》2017年03期

【摘要】：目的对比分析分化型甲状腺癌患者手术切除甲状腺组织后是否行淋巴结清扫及清扫范围的临床预后。方法连续选择2012年3月~2014年11月入我院确诊为分化型甲状腺癌患者共80例,该研究取得我院伦理委员会通过及患者、家属的知情同意权后,根据入院先后顺序将其分为对照组(n=36)和观察组(n=44),两组患者均行甲状腺全切或次全切除术,对照组不行或根据术者经验清扫最为可疑淋巴结,观察组术前行高频彩超检查,术中尽可能清扫最大范围淋巴结,对比两组患者临床效果及预后差异性。结果随访约1年,观察组肿瘤复发率显著低于对照组,生存率明显高于对照组,差异均有统计学意义(P0.05);两组患者的手术并发症发生率,比较差异无统计学意义(P0.05);术前高频彩超判断淋巴结转移与术中确诊比较,敏感性为97.4%,特异性为33.3%,阳性预测值为90.2%和阴性预测值为66.7%。结论结合术前高频彩超判断分化型甲状腺癌患者手术切除甲状腺组织后行淋巴结清扫及清扫范围有较高的准确性、效果好、复发率低,有较大的参考价值。
[Abstract]:Objective to compare and analyze the clinical prognosis of patients with differentiated thyroid carcinoma after resection of thyroid tissue after lymph node dissection. Methods A total of 80 patients with differentiated thyroid carcinoma were selected from March 2012 to November 2014. The right to informed consent was obtained from the ethics committee of our hospital and the informed consent of the patients and their families. According to the order of admission, the patients were divided into two groups: control group (n = 36) and observation group (n = 44). The patients in both groups underwent total thyroidectomy or subtotal thyroidectomy. The patients in the control group were unable to perform thyroidectomy or the most suspicious lymph nodes were cleared according to the experience of the operation. The observation group was examined by high frequency color ultrasound before operation. The largest range of lymph nodes were dissected during operation, and the clinical results and prognosis of the two groups were compared. Results following up for about one year, the recurrence rate of tumor in the observation group was significantly lower than that in the control group, and the survival rate was significantly higher than that in the control group (P0.05). The sensitivity, specificity, positive predictive value and negative predictive value were 97.4, 33.3, 90.2% and 66.7%, respectively. Conclusion the range of lymph node dissection and dissection after thyroidectomy in patients with differentiated thyroid carcinoma has high accuracy, good effect, low recurrence rate, and has a great reference value, combined with preoperative high frequency color Doppler sonography to determine the extent of lymph node dissection and dissection after operation in patients with differentiated thyroid carcinoma.
【作者单位】：江苏省泰州市人民医院超声科;
【分类号】：R445.1;R736.1

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