右侧喉返神经深层淋巴结清扫在甲状腺乳头状癌合并甲亢患者术中应用的临床分析

doi:10.3969/j.issn.1006-6233.2023.08.024

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摘要 目的: 分析右侧喉返神经深层淋巴结(LN-prRLN)清扫在甲状腺乳头状癌(PTC)合并甲亢患者术中应用的临床价值。方法: 选择我院2019年3月至2021年3月收治的115例右侧或双侧PTC合并甲亢患者,均行甲状腺全切及中央区淋巴结清扫及LN-prRLN清扫。分析患者淋巴结转移情况,并比较发生LN-prRLN转移、未发生LN-prRLN转移患者临床资料,运用Logistic多因素回归分析,总结LN-prRLN转移的影响因素。结果: 临床淋巴结阴性患者Ⅳa亚区+颈侧区、Ⅳb亚区+颈侧区及右侧颈淋巴结总转移率均低于临床淋巴结阳性患者,差异有统计学意义(P<0.05)。115例患者LN-prRLN总转移率为26.96%(31/115)。Logistic多因素回归分析示,以LN-prRLN转移情况为因变量,肿瘤直径≥1cm、病灶多发、病灶侵犯腺叶外、Ⅳa亚区转移、右侧颈淋巴结转移的影响因子具有统计学意义(P<0.05)。结论: PTC合并甲亢患者LN-prRLN转移率较高,对于存在LN-prRLN转移危险因素的患者,建议积极开展LN-prRLN清扫。

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	姚芮女
	刘晓菊
	叶利
	徐春乔

关键词 ：喉返神经, 淋巴结清扫, 甲状腺乳头状癌, 甲亢

Abstract：Objective: To analyze the clinical value of right recurrent laryngeal nerve deep lymph node dissection (LN-prRLN) in patients with papillary thyroid carcinoma (PTC) complicated with hyperthyroidism. Methods: From March 2019 to March 2021, 115 patients with right or bilateral PTC complicated with hyperthyroidism in our hospital were selected. All patients underwent total thyroidectomy, central lymph node dissection, and LN-prRLN dissection. The lymph node metastasis of patients was analyzed, and the clinical data of patients with LN-prRLN metastasis and those without LN-prRLN metastasis were compared. Logistic regression analysis was used to summarize the influencing factors of LN-prRLN metastasis. Results: The total metastasis rates of clinical lymph node negative patients in sub-region ⅳ a+cervical region, sub-region ⅳ b+cervical region and right cervical lymph nodes were lower than those in clinical lymph node positive patients, with statistical significance (P<0.05). The total metastatic rate of LN-prRLN in 15 patients was 26.96%(31/115). Logistic regression analysis showed that with LN-prRLN metastasis as the dependent variable, the influencing factors of tumor diameter ≥1cm, multiple lesions, invasion of extraglandular lobe, metastasis in subregion Ⅳa and right cervical lymph node metastasis were statistically significant (P<0.05). Conclusion: The LN-prRLN metastasis rate is high in PTC patients with hyperthyroidism. For patients with LN-prRLN metastasis risk factors, it is recommended to actively carry out LN-prRLN cleaning.

Key words： Recurrent laryngeal nerve Lymph node dissection Papillary carcinoma of thyroid Hyperthyroidism

基金资助:四川省卫生信息学会科研课题,(编号:2022036)

通讯作者: 徐春乔

引用本文:

姚芮女, 刘晓菊, 叶利, 徐春乔. 右侧喉返神经深层淋巴结清扫在甲状腺乳头状癌合并甲亢患者术中应用的临床分析[J]. 河北医学, 2023, 29(8): 1353-1358.
YAO Ruinv, LIU Xiaoju, YE Li, et al. Clinical Analysis of Deep Lymph Node Dissection of Right Recurrent Laryngeal Nerve in Patients with Papillary Thyroid Carcinoma Complicated with Hyperthyroidism. HeBei Med, 2023, 29(8): 1353-1358.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.08.024 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I8/1353

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