甲状腺乳头状癌不同术式选择对预后因素影响分析-外科学专业论文.docxVIP

— — PAGE 1— 摘 要 甲状腺乳头状癌不同术式选择对预后 因素影响分析 研究生：乌拉别克·毛力提 导师：赛力克·马高维亚 副教授 摘 要 目的：分析甲状腺乳头状癌不同术式对预后影响,探讨外科治疗最佳方案。方法： 回顾性分析 1998 - 2007 年新疆医科大学第一附属医院经手术和病理证实的甲状腺乳 头状癌患者资料，根据纳入和排除标准筛选出其中 99 例，对其肿瘤大小及手术方式 与术后淋巴转移及复发关系进行统计学分析。结果：甲状腺乳头状癌患者术后淋巴 转移及复发与其手术方式密切相关；对于癌肿直径小于等于 1cm 的甲状腺乳头状癌， 单纯腺叶切除或腺叶加峡部切除手术与全切术比较中，差别无明显统计学意义 （P0.05）,对于肿块直径大于 1cm 的癌肿，单纯腺叶切除或腺叶加峡部切除其术后 淋巴转移及复发明显高于甲状腺全切术，差别具有统计学意义（P0.05）。结论：甲 状腺乳头状癌应根据肿块大小选择行甲状腺腺叶切除、腺叶加峡部切除或全甲状腺 切除术，对于肿块直径小于 1cm 癌肿，腺叶切除或腺叶加峡部切除可以减少术后并 发症，提高患者生活质量。对于肿块大于 1cm 的癌肿，甲状腺全切术可以给予患者 治愈的希望，减少术后复发及转移。 关键词：甲状腺乳头状癌；手术治疗；预后 新疆医科大学医学硕士学位论文 Papillary thyroid carcinoma select different operations impact analysis of prognostic factors Postgraduate: Wulabieke·Maoliti supervisor: Sailike·M Associate Professor Abstract Objective: Analysis of papillary thyroid carcinoma of different operations on the impact of long-term complications, surgical treatment to explore the best option. Methods: Retrospective analysis of 1998-2007, Xinjiang Medical University First Affiliated Hospital confirmed by surgery and pathology of the thyroid papillary carcinoma patients with information, according to the inclusion and exclusion criteria were selected one of 99 cases, their surgical methods and postoperative complications in the relationship between were analyzed statistically. Results: The statistical analysis showed that cancer of the lymph node metastasis and recurrence had no correlation with sex (P 0.05), but is closely related with age (P 0.05), greater than 1cm for cancer of the thyroid papillary carcinoma, simple gland leaf removal or leaf add isthmus gland surgery, lymph node metastasis and postoperative recurrence was significantly higher than that of thyroid hysterectomy. Conclusion: papillary thyroid carcinoma should be based on age and tumor size line lobectomy of thyroid gland, glandular leaf add isthmic resection or total thyroidectomy, the tumor diameter is less than 1cm cancer, glandular leaf removal or leaf gland resection can add isthmic