甲状腺癌外科治疗体会.docVIP

甲状腺癌外科治疗体会 　　 【摘要】 目的 探讨甲状腺癌外科手术治疗的方式、效果及预后。方法 回顾性分析2000年2月至2010年2月六安市第二人民医院普外科收治的41例甲状腺癌患者的临床资料。结果 41例甲状腺癌中乳头状腺癌33例，滤泡状腺癌5例，髓样癌2例，未分化癌1例，均行手术治疗，术中冰冻及术后病理明确诊断，其中甲状腺微小癌6例为乳头状癌，术后随访时间1?5年，33例乳头状腺癌及5例滤泡状腺癌生活良好，1例髓样癌手术后一年死亡，1例未分化癌手术后6个月死亡。结论 甲状腺癌早期诊断、早期治疗、规范手术范围决定了患者预后，同时应加强术后的后续治疗。? 　　【关键词】 　　甲状腺癌;手术;预后 　　?? 　　Experience of surgical treatment of thyroid carcinoma 　　 　　ZHANG Qiao?qian, CHEN Ben?xin, YU Hai?feng. Lu?an Second People?s Hospital of Anhui Province of General Surgery,Lu?an 237006,China 　　? 　　 　　【Abstract】 Objective 　　To investigate the way, the effect and the prognosis of surgical treatment of thyroid carcinoma. Methods The clinical data of 41 patients with thyroid cancer at the general surgery of the second Hospital of Lu?an from February 2000 to February 2010 were analysed retrospectively. Results This 41 cases,33 of papillary thyroid carcinoma,5 of follicular thyroid carcinoma,2 of medullary thyroid carcinoma,1 of anaplastic carcinoma were treated with operation and confirmed by the intraoperative frozen section examinations and post?operative pathology.6 cases of thyroid microcarcinoma were papillary adenocarcinoma.The follow?up time after operation was from 1~5 years.33 cases of papillary adenocarcinoma and 5 cases of follicularadenocarcinoma have survived well. After surgery, 1 patient of medullary thyroid carcinoma died 1 year later and one patient of anaplastic carcinoma died 6 months later.Conclusion The prognosis of a patient with thyroid carcinoma depends on early diagnosis and therapy，standardized surgical extent, the post?operative followup treatment shoud be strengthened simultaneously.? 　　【Key words】 　　Thyroid carcinoma；Surgical treatment； Prognosis 　　 　　近年来，随着我国临床诊疗技术的提高，甲状腺癌的诊疗例数较前明显增加，统计我院普外科2000年2月至2010年2月共收治甲状腺癌患者41例，均经病理证实，对该组病例的诊断、治疗??预后等相关问题总结如下。? 　　1 临床资料? 　　1.1 一般资料 41例患者中，女28例，男13例，男女比例约为1:2，年龄18~62岁，平均(43±0.5)岁，病程1个月至3年，临床表现：所有患者均以颈部肿块就诊，甲状腺肿块多较坚硬、固定、表面不光滑、随吞咽上下活动度较小，其中伴颈部淋巴结肿大8例，1例未分化癌声音嘶哑，伴呼吸困难1例，术前均行B超检查，高度怀疑癌变