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目的:观察颈淋巴结阴性甲状腺乳头状癌术中清扫中央区淋巴结的临床意义。方法:选择颈淋巴结临床阴性甲状腺乳头状癌200例,随机为观察组和对照组各100例。观察组术中行中央区淋巴结清扫术,对照组不行中央区淋巴结清扫术。比较两组肿瘤大小、被膜侵犯情况、手术时间、术后第1天平均引流量、术后并发症发生情况和观察组中央区淋巴结检出、转移情况及相关影响因素分析。结果:两组肿瘤大小、被膜侵犯情况、手术时间、术后第1天平均引流量、术后并发症发生率比较,差异不显著(P>0.05)。观察组中央区淋巴结转移率为2 8.0%。Pearson相关分析结果显示,肿瘤直径>1 cm、年龄<45岁与中央区淋巴结转移呈非常显著正相关(P<0.01)。结论:颈淋巴结临床阴性甲状腺乳头状癌中央区淋巴结转移率较高,有必要行中央区淋巴结清扫术。
Objective: To observe the clinical significance of lymph node dissection in the central lymph node of cervical lymph node-negative thyroid papillary carcinoma. Methods: 200 cases of clinically negative thyroid papillary carcinoma of cervical lymph nodes were selected and randomly divided into observation group and control group with 100 cases each. In the observation group, central lymph node dissection was performed in the operation group while the control group was not operated on lymphadenectomy in the central area. The tumor size, invasion of the capsule, operation time, the average drainage volume on the first postoperative day, the incidence of postoperative complications, the detection and metastasis of lymph nodes in the central area of the observation group and the related influencing factors were compared between the two groups. Results: There was no significant difference in the size of the tumor, invasion of the capsule, operation time, average drainage volume on the first day after operation, and postoperative complication incidence (P> 0.05). The central lymph node metastasis rate in observation group was 28.0%. Pearson correlation analysis showed that the tumor diameter> 1 cm, age <45 years and central lymph node metastasis was significantly correlated (P <0.01). Conclusion: There is a high lymph node metastasis rate in the central region of clinically negative thyroid papillary carcinoma of cervical lymph nodes. It is necessary to perform central lymph node dissection.