Abstract: Objective To explore the clinical value of level Ⅶ Neck dissection to differentiated thyroid carcinoma. Methods A total of 156 patients in Shunde Hospital from June 2015 to May 2017 were included in the study，in which 78 cases underwent thyroidectomy and level Ⅵ + level Ⅶ neck lymph nodes dissection（study group），and another 78 cases underwent thyroidectomy and level Ⅵ neck dissection（control group）alone. The number of lymph nodes，operation time，blood loss and postoperative complications were collected and analyzed in two groups. Results Central compartment lymph node metastasis was found in 52.56% of study group ，and in 51.28% of control group ，with no significant difference（χ2=3.34，P=0.345）. In study group，14.10% of level Ⅶ lymph nodes was found invasive， which was lower than other parts of central compartment lymph node district（52.56%，41/78）. Averagely， 7.7±1.2 lymph nodes were found in study group，whereas 5.2±1.1 lymph nodes in control group，which was significant difference（t=0.38 ，P=0.036）. In all cases of this group ，there was no difference in the average hospitalization stay ， operation time ， blood loss ， postoperative blood loss （P>0.05）. Conclusion DTC has high metastasis rate in the level Ⅶ. So it is necessary to clean lymph nodes in the level Ⅶ，which provide more accurate for postoperative efficacy of differentiated thyroid carcinoma.

Key words: lymph nodes, thyroid carcinoma, recurrent laryngeal nerve, neck dissection

摘要： 目的 探讨Ⅶ区淋巴清扫在分化型甲状腺癌术中的意义。方法 分析南方医科大学顺德医院甲状腺外科 2015 年 06 月至 2017 年 05 月间确诊分化型甲状腺癌的 156 例患者，分为行Ⅵ区+Ⅶ区淋巴清扫的实验组和单纯行Ⅵ区淋巴清扫的对照组。统计两组患者淋巴结情况，术中的出血量、手术时间、术后并发症、住院时间等情况。结果 156 例患者手术均成功完成，观察组和对照组患者中央区淋巴结转移的发生率分别为 52.56%（41/78）和 51.28%（40/78），差异无统计学意义（χ2=3.34，P=0.345）。观察组发生Ⅶ区淋巴结转移的患者 11 例（14.10%，11/78），转移发生率显著低于中央区其他部位淋巴转移发生率（52.56%，41/78），差异有统计学意义（χ2=3.34，P=0.001）。观察组和对照组转移的阳性淋巴结数量分别为（7.7±1.2）和（5.2±1.1），差异有统计学意义（t=0.38，P=0.036）。两组患者在手术时间、术中出血量、术后出血量均无明显差异（P>0.05）。结论 Ⅶ区淋巴也是分化型甲状腺癌的淋巴结转移好发位置，Ⅶ区淋巴清扫增加了中央区淋巴结的阳性检出率，为分化型甲状腺癌的术后疗效提供更确切的保障。

关键词: 淋巴结, 甲状腺癌, 喉返神经, 颈淋巴结清扫术