多功能保留在颈淋巴结清除术中的应用

目的:探讨颈淋巴结清除术中,多种功能保留的可行性及意义.方法:选择1991年8月至2002年8月功能性颈淋巴结清除术517例.其中甲状腺癌451例(87.23%),喉癌30例(5.80%),舌癌22例(4.26%),牙龈癌及上颌窦癌10例(1.93%),其它4例(0.77%).结果:术后患者随访,最长13年,最短1年,中位3年4个月,均无复发.术后功能恢复视保留功能的多少而定,保留颈横动脉能保护膈神经与臂丛神经免受损伤.结论:甲状腺癌选择性颈淋巴结清除术中除颈外静脉外,均应保留功能.而在其它部位的转移性鳞状细胞癌中在不影响根治的情况下也应尽可能多的保留功能,特别是耳大神经、枕小神经、锁骨上皮神经及副神经.

The Application of Multifunction Preserved in Neck Dissection

Objective: To evaluates the probability and value of multifunction preserved in neck dissection. Methods: Five hundred seventeen patients were performed with the functional neck dissection from August 1991 to August 2002 and 451 of the patients (87.23%) had thyroid cancer, 30(5.8%) had larynogeal cancer, 22(4.26%) tongue cancer, 10(1.93%) gingival or maxillary sinus cancer and 4(0.77%) other cancer. Results: The median follow up period is 3.33 years (between 1 and 13 years). All the patients in the study had no recurrence during the follow up period. The more nerves were reserved, the more functions were intact after operation. The reserved transverse cervical artery can protect brachial plexus and phrenic nerve from damage. Conclusions: The important texture must be preserved beside the jugular superficial vein in selective cervical dissection of thyroid cancer. More cervical functions should be reserved, such as the nerves of accessory, great auricular, lesser occipital, supraclavicular cutaneous, etc, which hadn't any the influence of eradicated effect on metastasis squamous cell cancer.