分化型甲状腺癌手术治疗方法的探讨  

Surgical treatment of differentiated thyroid cancer

作　　者：刘春萍[1] 明洁[1] 石岚[1] 李治 黄韬[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院乳腺甲状腺外科,湖北武汉430022

出　　处：《中国普通外科杂志》2008年第5期409-411,共3页China Journal of General Surgery

摘　　要：目的探讨分化型甲状腺癌的手术治疗方法。方法回顾性分析4年间收治的759例分化型甲状腺癌患者的临床资料,从甲状腺切除范围、颈部淋巴结清扫情况两方面探讨分化型甲状腺癌的治疗。结果全组患者均接受双侧甲状腺全切术。术后病理学检查结果显示,多灶性甲状腺癌占23.6%,合并结节性甲状腺肿、桥本病和Grave病等的患者共381例,占50.2%。638例行不同范围的颈淋巴结清扫术,487例(76.3%)有颈淋巴结转移。术后并发症发生率为3.4%。结论结合国外临床指南及该组临床资料分析,建议将双侧甲状腺全切术作为我国分化型甲状腺癌的常规手术方法,并结合患者的肿瘤分期,考虑是否行颈淋巴结清扫术。Objective To investigate the method of surgical therapy in patients with differentiated thyroid cancer. Methods The clinical data of 759 patients with differentiated thyroid cancer treated in our hospital in recent 4 years were retcospectively analysed. Results Bilateral thyroidectomy was undertaken in all our patients. Pathological investigation indicated that muhifocal differentiated thyroid carcinoma was found in 179 cases （23.6%） , and co-existence of muhinodular goiter, Hashimoto disease or Grave＇s disease was found in 381 cases （ 50.2 % ）. Among the 638 cases who received lymph node dissection of different extents, metastasis in cervical lymph nodes was found in 487 cases （ 76. 3% ） . Complications after surgery were found in 26 cases （ 3. 4% ） . Conclusions Combining the guidelines from abroad and outcome of this group, it is recommended that bilateral thyroidectomy should be employed as routine therapy for differentiated thyroid carcinoma in China. The decision for lymph node dissection can be considered according to the stage of the tumor.

关 键 词：甲状腺肿瘤 外科学 甲状腺癌 分化型 治疗 颈淋巴结清扫术 

分 类 号：R736.1[医药卫生—肿瘤]