甲状腺癌的外科治疗分析  

Surgical treatment of thyroid cancer

作　　者：伊海金[1] 张宝泉[2] 

机构地区：[1]首都医科大学附属北京天坛医院耳鼻咽喉科,北京100050 [2]中国协和医科大学中国医学科学院附属北京协和医院耳鼻咽喉头颈外科,北京100730

出　　处：《山东大学耳鼻喉眼学报》2010年第4期10-12,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨甲状腺癌的外科治疗相关问题。方法对28例经手术治疗的甲状腺癌患者的临床资料进行回顾性分析。结果术中常规快速冰冻切片病理诊断,术后常规病理切片确诊,术中、术后病理不符2例;乳头状癌22例,滤泡状癌2例,淋巴瘤1例,乳头状癌合并低分化癌1例,髓样癌1例,小细胞癌1例;扩大甲状腺全切2例,甲状腺全切8例,腺叶加峡部切除10例,一侧腺叶、峡部加对侧腺叶大部切除术7例,肿物局部切除1例;双侧颈清术5例,单侧颈清术6例。本组无手术死亡,术后新发现声嘶1例,出现抽搐2例。甲状腺全切者常规甲状腺素替代治疗。结论术中冰冻切片病理检查有助于甲状腺癌的诊断和术式选择;病理类型、癌肿侵犯范围是决定手术范围的重要因素。Objective To explore the relative problem of surgical treatments of thyroid cancer. Methods 28 patients were diagnosed both by intra-operation frozen section and post-operation paraffin section. Results the result of two patients differed on intra-operation and post-operation pathology; 22 had papillary carcinoma, 3 had follicular carcinoma, 1 had papillary carcinoma and poorly differentiated carcinoma, 1 had malignant lymphoma, 1 had medullar carcinoma, and 1 had small cell cancer. Concerning the operation patterns, 2 had enlarged total thyroidectomy, 8 had total thyroidectomy, 10 had unilateral lobectomy plus isthmectomy, the lobe, isthmus and the other patial lobe was resected in 7 patients, the tumor was resected locally in 1 patient, 5 had bilateral cervical node dissection, and 6 had unilateral cervical node dissection. There were no deaths, 1 had newly found hoarseness due to vocal cord paralysis, and 2 had tic due to hypocalcemia. Conclusion Intra-operation frozen section was helpful to the diagnosis and operation of thyroid cancer. The pathology and extent of the cancer is an important factor to decide the opration method.

关 键 词：甲状腺癌 外科手术 

分 类 号：R736.1[医药卫生—肿瘤]