摘要
目的分析甲状腺癌手术中甲状旁腺误切相关危险因素。方法回顾性分析2014-10-01—2015-10-01中国医学科学院北京协和医学院肿瘤医院头颈外科收治的1047例初治甲状腺乳头状癌病人资料,包括病人一般情况、病灶及手术情况、术中是否使用纳米碳等,按术后病理学检查是否有甲状旁腺分为两组,比较两组病例各因素差异。另以误切甲状旁腺所处病理标本位置分腺叶标本组、中央区标本组,比较术中是否应用纳米碳对两组位置甲状旁腺误切率的影响。结果术后病理学检查报告见甲状旁腺198例(占18.9%)。单因素分析提示男性、病灶侵犯被膜、颈部淋巴结清扫者有较高的甲状旁腺误切率,差异具有统计学意义。多因素分析提示男性、病灶侵犯被膜是甲状旁腺误切的独立危险因素。在不同位置甲状旁腺误切的比较中,应用纳米碳后对腺叶标本组、中央区标本组病例虽均具有减少甲状旁腺误切的作用,但差异仅对前者有统计学意义。结论甲状腺癌手术中,男性、病灶侵犯被膜、颈部淋巴结清扫是甲状旁腺误切的高危因素,应用纳米碳对邻近甲状腺腺体或位于腺体内的甲状旁腺有更好的保护效果。
Objective To analyze the risk factors of parathyroidectomy during thyroid cancer surgery.Methods The clinical data of 1047 patients with newly discovered papillary thyroid carcinoma who underwent surgery in Department of Head and Neck Surgery, Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from October 1, 2014 to October 1, 2015 were analyzed retrospectively. All patients were divided into two groups according to postoperative pathology whether parathyroid gland exists and the various factors were compared between two groups. Additionally,parathyroidectomy rate among the different locations were also compared according to whether to use the nano-carbon. Results The overall parathyroidectomy rate was 18.9%. Univariate analysis showed that patients with the features of males,invasion of the capsule,neck lymph node dissection had a higher rate of incidental parathyroidectomy,and the difference was significant statistically. Multivariate analysis showed that males and invasion of the capsule were independent risk factors for incidental parathyroidectomy. In the comparison of incidental parathyroidectomy locations,it demonstrated that nano-carbon had protective effect on the parathyroid glands located in intrathyroid or juxtathyroid and central location,but the difference was statistically significant only in the former. Conclusion Males,invasion of the capsule,neck lymph node dissection are the risk factors of incidental parathyroidectomy. The application of nano-carbon has a better protective effect on parathyroid glands which are located in intrathyroid or juxtathyroid.
出处
《中国实用外科杂志》
CSCD
北大核心
2017年第9期1028-1031,共4页
Chinese Journal of Practical Surgery
关键词
甲状腺癌
甲状旁腺
误切
纳米碳
thyroid carcinoma
parathyroid
incidental resection
nano-carbon
