中国实用外科杂志

• 专题笔谈 • 上一篇    下一篇

甲状腺癌颈淋巴结清扫术常见并发症及其防治

韦    伟,李    朋   

  1. 北京大学深圳医院甲状腺外科,广东深圳518036
  • 出版日期:2017-09-01 发布日期:2017-09-05

  • Online:2017-09-01 Published:2017-09-05

摘要:

颈淋巴结清扫术是甲状腺癌重要的治疗手段,但也会导致术后出血、神经损伤、淋巴漏、永久性甲状旁腺功能低下等各种并发症,不同程度地影响病人的康复、生活质量,甚至威胁生命。为了减少术后并发症的发生,应注意以下几点:(1)严格掌握手术指征,对合适病人行合理范围的手术。(2)熟悉颈部局部解剖,不仅手术全程要有预防意识,还能够正确预判什么区域会遇到什么重要的组织结构。(3)熟悉各种并发症的临床症状和处理时机、方法,避免错上加错。(4)规范化培训。应在高年资医生指导下,积累一定病例数后再独立开展颈淋巴结清扫术。

关键词: 颈淋巴结清扫术, 并发症, 甲状腺癌

Abstract:

Major complications and prevention of cervical lymph node dissection for thyroid carcinoma        WEI Wei, LI Peng.Department of Thyroid Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China
Corresponding author:WEI Wei, E-mail:rxwei1123@163.com
Abstract    Cervical lymph node dissection is a crucial method of surgical treatment of thyroid carcinoma.But it may also induce the occurrence of various complications, affect the life quality of patients,prolong hospital stay and increase hospital cost in different extent. The measures to reduce the complications of cervical lymph node dissection include:Firstly, it need to control the indications of cervical lymph node dissection, perform the reasonable range of surgery on the appropriate patient;Secondly, it also need to be very familiar with the cervical anatomy, so that the surgeon can prejudge the possibility of encountering important organizational structure in different region during the surgery;Thirdly, surgeons should understand the clinical symptoms,treatment opportunity and methods for the complications; Finally, the junior surgeons should received standardize training strictly and accumulate a number of cases under the guidance of senior surgeons before carrying out cervical lymph node dissection independently.

Key words: cervical lymph node dissection, complications, thyroid carcinoma