甲状腺乳头状癌136例临床分析  

Papillary carcinoma of thyroid:a clinical analysis of 136 cases

作　　者：饶南燕[1] 谢敏[1] 胡小云[1] 李里香[2] 曹家庆[1] 涂群飞[1] 张文昌[2] 

机构地区：[1]南昌大学第二附属医院普外科,江西南昌330006 [2]南昌大学第二附属医院病理科,江西南昌330006

出　　处：《中国实用外科杂志》2008年第3期192-193,共2页Chinese Journal of Practical Surgery

摘　　要：目的探讨甲状腺乳头状癌的诊断及并发症的处理。方法回顾性分析1995-2004年南昌大学第二附属医院经手术和病理证实的136例甲状腺乳头状癌的临床资料。结果术中冰冻切片诊断符合率为98.2%(111/113),显著高于术前B超、CT和细针穿刺细胞学检查,上述三者的正确诊断率分别为25.8%(16/62)、80.0%(24/30)和78.1%(25/32)。术后低钙血症、喉返神经麻痹及乳糜漏的发生率分别为8.8%(12/136)、2.2%(3/136)和1.5%(2/136)。结论术中冰冻快速切片是诊断甲状腺乳头状癌的可靠依据;胸导管漏口-大隐静脉-颈内静脉搭桥吻合术是治疗高流量乳糜漏的好方法。Objective To evaluate the diagnosis and the treatment of thyroid papillary carcinoma and its complications. Methods The clinical data of 136 cases of thyroid papillary carcinoma confirmed by surgery and pathology from 1995 to 2004 in the Second Affiliated Hospital of Nanchang University were analyzed retrospectively. Results The coincidence rate of diagnosis for thyroid papillary carcinoma by intraoperative frozen section was 98.2% （ 111/113 ）. It was significantly higher than that by uhrasonography （ 25.8% , 16/62 ） , CT （ 80. 0% , 24/30 ） and fine needle aspiration biopsy （78. 1% ,25/32）. Hypocalcemia after surgical event could be documented in 8.8% of 136 cases, recurrent laryngeal nerve injury in 2.2% of cases and chyle leakage in 1.5% of cases. Conclusion The intraoperative frozen section can provide reliable evidence for the diagnosis of thyroid papillary carcinoma. The peripheral tissues of thoracic duct fistulagreat saphenous vein-internal jugular vein anastomosis is a good way to treat high flow of chyle transudation.

关 键 词：甲状腺癌 术中冰冻 乳糜漏 

分 类 号：R6[医药卫生—外科学]