【摘要】 目的:比较颈部2个皮纹切口与传统"L"形切口颈淋巴结清扫术对患者机体血清创伤细胞因子白细胞介素(IL)-2,IL-6,C-反应蛋白(CRP)的影响。方法:对2008年12月至2011年7月在新疆医科大学附属肿瘤医院行保留皮神经颈淋巴结清扫术(即保留皮神经的Ⅱ,Ⅲ,Ⅳ,Ⅵ区清扫)的58例甲状腺癌患者按照患者意愿分为2组,第1组26例采用颈部2个横行皮纹小切口行颈淋巴结清扫术,第2组32例采用传统颈部"L"形切口行颈淋巴结清扫术,检测并比较2组所有患者的术前1 d、术后1,3,5 d血清细胞因子IL-2,IL-6,CRP的含量。结果:2个皮纹切口与"L"形切口术后第1天血清IL-2含量均有下降,但变化差异无统计学意义(P>0.05),术后第3天开始两组均恢复到术前水平;两组术后第1天血清IL-6值均升高,术后第3天均有下降,且术后第5天两组均基本恢复到术前水平;两组血清CRP含量术后第1,3天和5天均较术前明显上升,差异有统计学意义(P<0.05),2个切口和"L"形切口术前和术后组间差异无统计学意义(P>0.05)。术后随访8~40个月未出现局部及颈部淋巴结复发。结论:颈部2个皮纹切口颈淋巴结清扫术与传统"L"形颈淋巴结清扫术相比,对机体血清应激细胞因子影响相当,并不增加创伤性,其在不影响颈淋巴结清扫效果的同时又兼顾了功能与美容,是甲状腺癌保留皮神经的Ⅱ,Ⅲ,Ⅳ,Ⅵ区淋巴结清扫的一种较为理想的手术入路。更多还原

【Abstract】 Objective: To compare the trauma of neck dissection on the human body between two-striae incision and traditional "L" shaped incision by serum trauma cytokines.Methods: Patients with differentiated thyroid carcinoma hospitized from December 2008 to July 2011 were divided into 2 groups according to their own will.The first group 26 patients) had two-striae incision and the second group 32 patients) had traditional "L" shaped incision.The serum level of interleukin(IL)-2,IL-6 and C-reactive protein(CRP) in all patients were examined 1 day before and 1,3 and 5 days after the surgery.Results: No statistical significance was found between the 2 groups,although level of IL-2 decreased 1 day after the surgery,but recovered to normal 3 days later.The level of IL-6 in both groups increased 1 day after the surgery,began to decrease 3 days after the surgery,and recovered to normal 5 days after the surgery.The level of CRP suggested statistical significance(P<0.05),which increased obviously 1,3 and 5 days after the surgery.No statistical difference was found before or after the surgery between the 2 groups(P>0.05).After follow-up for 8–40 months,no local recurrence or lymph node metastasis was found.Conclusion: Compared with the traditional "L" shaped incision,two-striae incision in neck dissection does not increase the serum level of trauma cytokines and trauma to human body after the surgery.Two-striae incision is an ideal surgical approach to differentiated thyroid carcinoma.更多还原