分化型甲状腺癌再次手术39例临床分析  

Clinical analysis of 39 well-differentiated ttyroid carcinoma paients

作　　者：侯开庆[1] 彭勃[1] 赵国栋[1] 张罡[1] 

机构地区：[1]海口市人民医院普外科,海南海口570208

出　　处：《中国热带医学》2011年第5期591-592,共2页China Tropical Medicine

摘　　要：目的探讨分化型甲状腺癌术前正确诊断和合理手术术式选择。方法对39例分化型甲状腺癌再次手术的临床资料进行回顾性分析。结果术前28例误诊为甲状腺瘤,8例误诊为结节性甲状腺肿。首次手术行单纯性肿瘤切除30例,患叶甲状腺次全切除6例,行腺叶加峡部切除3例。术前、术中32例未做细胞及病理学检查。结论对甲状腺结节患者,应行细针穿吸(FNAC)及术中冰冻切片(FS)检查。并重视区域淋巴结的检(探)查,以确定分化型甲状腺癌诊断,根据病期选择手术术式。如无条件行FNAC及FS,对一叶单发或多发甲状腺结节的可疑病例,宜选择甲状腺叶加峡部切除术术式治疗。Aim To explore the correct pre-operative diagnosis of diferentiated thyroid cancer.Methods The clinical data of 39 cases with diferentiated thyroid cancer were analyzed retrospectively.Results The 28 cases were misdiagnosed as thyrophyma and 8 cases were misdiagnosed as nodular goiter before first operation.Tumor resection of 30 cases was performed the subtotal lobectomy was performed in 6 cases and the lobectomy plus inthmusectomy was performed in 3 cases at first operation.32 cases were not given cytological and pathological identification before and during first operation.Conclusion Fine-needle aspiration cytology（FANC） and frozen section（FS） should be done on thyroid nodule patients,more attention should be paied to local lymphodes in order to ensure the diagnosis of differentiated thyroid cancer and to choose the operation methods according to stages of disease.It＇s proper to choose lobectomy plus isthmusoctomyin uncertained cases with single or multiple thyroid nodules if FNAC and FS were not available.

关 键 词：甲状腺癌 细针穿吸 冰冻切片 再手术 

分 类 号：R736.1[医药卫生—肿瘤]