颈部肿块26例诊治与反思  

Diagnosis and Treatment of 26 Cases of Cervical Mass

作　　者：刘斌[1] 柏磊[1] 

机构地区：[1]宿迁市中医院,江苏宿迁223800

出　　处：《现代保健（医学创新研究）》2008年第15期20-21,共2页

摘　　要：目的探讨颈部肿块的诊断、治疗与预后。方法回顾性分析2005年2月～2007年4月宿迁市中医院外科病房及门诊收治的26例颈部肿块的病例资料。结果25例择期手术切除，24例常规病理检查，其中3例术中行冰冻检查。1例患者拒绝病理检查。1例行FNAC检查后保守治疗。住院18例术前皆有入院常规及生化检查，其中8例有B超、CT检查。7例没有完善的检查即门诊手术切除。门诊病历几乎术前以“颈部肿块，性质待定”为诊断。住院患者也大多以“颈部肿块，转移瘤？甲状腺占位”为诊断。术后切口甲级愈合22例、乙级埝合3例。无一例医患纠纷，患者满意度无考证。结论不重视或懒于术前的进一步诊断，对术前确诊的重要性认识不足。过去不够正确的观念仍延用。即为了尽快确诊，一开始就要求病人接受肿块切除活检。离了点全面的系统的鉴别诊断知识与经验，少了点临床思维，缺了点FNAC、MRI等先进的术前检查，重了点手术一外科医生的唯一。Objective Trachelophyma aim to explore the diagnosis, treatment and prognosis. Methods A retrospective analysis from February 2005 to April 2007 Suqian City hospital wards and out - patient treated 26 cases of the cases of cervical mass information. Results The results of 25 cases of elective surgery and 24 cases were examined ,Three cases in which Bank of frozen inspection. One patient refused pathological examination. FNAC is a routine inspection after conservative treatment. Hospitalization 18 patients were admitted there are conventional and biochemical tests, Eight patients with B - CT. Seven cases without proper inspection or outpatient surgical resection. Out - patient medical records almost to preoperative ＂trachelophyma nature to be determined＂ for the diagnosis. Most patients with ＂neck tumors, metastases？ Thyroid footprint＂ for the diagnosis. A healing incision 22 cases of B healing three cases. No patient disputes, the patient satisfaction without verification. Conclusion No or lazy when it comes to the further preoperative diagnosis, preoperative diagnosis of sufficient understanding of the importance. Not correct past attitudes extension. That is, in order to expedite the diagnosis and the beginning of patients receiving the request mass excision biopsy. From the point of the comprehensive system in the differential diagnosis of knowledge and experience, just does not have clinical thinking, and none of the points FNAC, MRI and other advanced preoperative examination, a point re - surgery - the only surgeon.

关 键 词：颈部肿块 术前确诊 

分 类 号：R653[医药卫生—外科学]