中央区淋巴结清扫术在临床颈侧淋巴结阴性甲状腺乳头状微小癌中的应用研究

目的 探讨中央区淋巴结清扫术在临床颈侧淋巴结阴性甲状腺乳头状微小癌（PTMC）中的意义.方法 回顾性分析72例临床颈侧淋巴结阴性PTMC患者的临床资料,患者均行患侧甲状腺、峡部切除及对侧甲状腺腺叶次全切术＋中央区淋巴结清扫术,术后长期随访.结果 24例出现中央区淋巴结转移,48例未出现中央区淋巴结转移,随访1.5～4.5（3.4±1.1）年,4例患者出现喉返神经麻痹,均在4个月内恢复正常.4例患者术后第3年发现颈部淋巴结转移,余患者均未见转移.结论 临床颈侧淋巴结阴性PTMC患者易出现中央区淋巴结转移,行中央区淋巴结清扫术对临床颈侧淋巴结阴性PTMC有较重要的应用价值,可降低并发症、改善患者预后.

Application of central region cervical lymph nodes dissection in papillary thyroid microcarcinoma with clinically node-negative sides of neck stage

Objective To analyze the application value of central region cervical lymph nodes dissection in papillary thyroid microcarcinoma （PTMC） with clinically node-negative sides of neck stage.Methods Clinical data of 72 PTMC patients with clinically node-negative sides of neck stage were collected,and they were underwent total thyroidectomy,isthmic portion excision and contralateral lobus glandularis excision and neck dissection.A long term follow-up was made.Results Twenty-four patients were found central region cervical lymph nodes metastasis while other 48 patients were not found central region cervical lymph nodes metastasis.Followed up for 1.5-4.5 （3.4 ± 1.1） years,4 patients were found recurrent laryngeal nerve paralysis and recovered within 4 months.Four patients were found central region cervical lymph nodes metastasis after operation the 3rd years.Conclusions There is a tendency for PTMC patients with clinically node-negative sides of neck stage to occur central region cervical lymph nodes metastasis,it＇s necessary to perform prophylactic central region dissection.It can decrease the complications and improve the prognosis.