原发性甲状腺癌手术经验和体会  

The experience and understanding of surgical treatment of primary thyroid carcinoma primary thyroid carcinoma

作　　者：李宝金[1] 刘晓平[1] 易辛[1] 于志强[1] 何和平[1] 韦伟[1] 朱立元[1] 

机构地区：[1]北京大学深圳医院普外科,广东深圳518036

出　　处：《罕少疾病杂志》2006年第4期4-6,15,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的总结原发性甲状腺癌手术治疗的经验和体会。方法回顾性分析我院1994年4月～2005年4月收治的经手术病理确诊的92例患者临床资料,并结合有关文献分析原发性甲状腺癌(PTC)的癌前病变及手术方式的选择。结果92例原发性甲状腺癌中,乳头状癌85例(92.9%),滤泡状癌和髓样癌各2例,未分化癌1例,非典型腺癌恶变和癌变各1例。伴颈部淋巴结转移20例(21.74%),伴同时性肺转移2例(2.17%),合并结节性甲状腺肿18例(癌变3例),合并桥本氏甲状腺炎7例(癌变2例)。治疗行甲状腺癌根治术76例,甲状腺癌根治术加患侧颈淋巴清扫术14例,甲状腺癌根治术加肺转移灶切除术(肺叶切除术)2例。结论乳头状甲状腺癌治疗首选甲状腺癌根治术,有孤立远处转移灶的可行甲状腺癌根治术加远处转移灶切除术,建议推行全甲状腺切除术加终身服用甲状腺素的治疗方案。Objective To summarize the experience and understanding of surgical treatment of primary thyroid carcinoma （PTC）. Methods By way of the retrospective clinical analysis of 92 patients with PTC, some details combined with related literature were construed involving high dangerous factor, clinical characteristic and surgical treatment of PTC. Results 92 cases of PTC mostly were papillary thyroid carcinoma （92.9%）. 20 cases had neck lymph metastasis, and 2 cases were simultaneously companied with lung metastasis. 18 cases were associated with nodular goiter, and 7 cases associated with chronic lymphocytic thyroiditis. Among the 92 cases, 76 cases underwent the radical thyroid resection, 14 were treated with radical thyroid resection plus neck lymph nodes clean up surgery, and 2 with radical thyroid resection addition lung lobectomy. Conclusion The first choice of therapy for PTC should be radical thyroid resection, and added metastasis area resection when accompanied with sole distance metastasis. It should be recommended to perform treatment project including total thyroid resection and taking medicine for thyroid carcinoma.

关 键 词：甲状腺癌 全甲状腺切除术 慢性甲状腺炎 

分 类 号：R735.31[医药卫生—肿瘤]