分區(qū)性頸清掃術(shù)在聲門上型喉鱗癌臨床N-,0-病例中的療效分析.pdf

1、山西醫(yī)科大學(xué)碩士學(xué)位論文分區(qū)性頸清掃術(shù)在聲門上型喉鱗癌臨床N病例中的療效分析姓名：張海鵬申請學(xué)位級別：碩士專業(yè)：耳鼻咽喉—頭頸外科指導(dǎo)教師：皇甫輝20090401pq醫(yī)科人學(xué)七，寸制臨床醫(yī)學(xué)碩1j々qk學(xué)化論文Slectiveneckdissectioninthemanagementoftheclinicallynegativeneck(No)supraglotticlaryngealsquamouscellcarcinomaAbstr

2、actObjective：ToinvestigatethecharacteristicsofthecervicallymphnodemetastasisintheclinicalNopatientswithsupraglotticcarcinomaandtocomparetheeffectivenessofselectiveneckdissection(SND)withmodifiedradicalneckdissection(MND)

3、，radiotherapy，“waitandsee”，combinationofneckdissectionandneckirradiationforthemanagementofitMethods：FivetreatmentgroupswithclinicalNosupraglotticsquamouscellcarcinomawereretrospectivelycompared：32patientswhoweretreatedwi

4、thMNDbetweenMarchof1989andMarchof2006；and26patientswhoweretreatedwithSNDbetweenJanuary1995andMarch2006：and22patientswhoweretreatedwith“waitandsee’betweenmarch1989andmarch2006；18patientswhoweretreatedwithradiotherapybetwe

5、enmarch1989andmarch2006；and35patientswhoweretreatedwithwithneckdissectionandneckirradiationTocollectandresearchthelymphnodesfromneckdissectionResults：93werestudiedTheoccultcervicalnodemetastases(pN)werefoundin215％(20／93)

6、and11locateatlevelII(555％)，8relatedwithlevelIIandIII(40O％)1wasinII，IIIandIV1015nodesweregeted，31werepN，20(645％)wasinlevelII，10wasinlevelIII(323％)，30wasinlevelIIandIII，about968％1nodewasinlevelIV(31％)The5yearsurvivalratesf

7、orSNDpopulationwas703％，whichwasnotstatisticallydifferentfromtheMNDpopulation(725％)andradiotherapy(726％)andcombinedtherapy(698％)，butstatisticallydifferentfromthe“waitandsee”(358％)Complicationsandperiodofhospitalizationwer

8、ebothdecreasedinSNDgroupcomparisonofMNDgroup(115％VS438％，18daysVS28days)Conclusion：1LevelIIandIIIlymphnodesweremainlyrelatedintheclinicalNopatientswithsupraglotticsquamouscellcarcinomaSolevelII～IIIdissectioncouldbeperform

9、edinallpatientswithclinicalNowithsupraglotticlaryngealsquamouscellcarcinoma2Comparingtothe“waitandsee”SNDaddsuevivaladvantage3Comparingtothemodifiedradicalneckdissectionandradiotherapyandcombinedtherapy：(DSNDwasgoodatcon