甲状腺锥体叶腺瘤伴囊性病变7例的诊治及临床效果观察  

Diagnosis and treatment of lobus pyramidalis glandulae thyroideae adenoma accompanied by cystic lesions in 7 cases and clinical therapeutic effects

作　　者：李思齐[1] 陈翰博[1] 张力[1] 张志超[1] 向东[2] 

机构地区：[1]昆明医科大学第二附属医院急诊医学部急诊外科,昆明650101 [2]昆明医科大学第二附属医院甲状腺乳腺外科,昆明650101

出　　处：《西南国防医药》2015年第10期1114-1116,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的分析7例甲状腺锥体叶腺瘤伴囊性病变患者诊治方法及手术治疗的临床效果,总结其鉴别诊断、减少误诊的体会。方法回顾性分析7例甲状腺锥体叶腺瘤伴囊性病变患者的临床资料,所有患者经彩超和CT检查后高度怀疑为锥体叶肿瘤,颈丛麻醉下行甲状腺肿块切除术并送病理检查确诊为腺瘤伴囊性病变,分析手术情况、术后复发情况及治疗前后甲状腺功能变化情况。结果本组手术均顺利完成,术后未发生1例切口感染、邻近软组织损伤等并发症;术后随访6-12个月,无一例复发。与治疗前比较,术后6个月患者T3、T4、FT3、FT4、TPOAb无明显变化（P〉0.05）,而TSH有所下降,TGAb有所上升（均P〈0.05）。结论甲状腺锥体叶腺瘤伴囊性病变在影像学、解剖学、病理学检查上均有其特点,完善的术前检查、手术切除、病理学检查能够较好地消除肿瘤,减少误诊,术后复发率较低,对甲状腺功能影响较小。Objective To investigate the diagnostic and treatment method of lobus pyramidalis glandulae thyroideae adenoma accompanied by cystic lesions in 7 cases and the clinical effects of surgical treatment, and to summarize the experiences of differential diagnosis and reducing misdiagnosis. Methods A retrospective analysis was made in the clinical data of seven patients with lobus pyramidalis glandulae thyroideae adenoma accompanied by cystic lesions. All the patients were highly suspected as pyramidal lobe tumor after the ultrasound and CT examination. They received thyroid tylectomy under cervical plexus anesthesia were finally diagnosed as adenoma accompanied by cystic lesions after pathological examination. Analysis was made in surgery situations,postoperative recurrence, and the changes of thyroid function before and after the treatment. Results The surgeries were all successfully completed. Complications such as postoperative incisional wound infection and nearby soft tissue injury did not occur.During the postoperative follow-up for 6 to 12 months, there was no case of recurrence. Compared with the indexes before the treatment, there was no obvious changes in T3, T4, FT3, FT4, and TPOAb 6 months after the treatment（P〈 0.05）. However, TSH decreased, and TGAb increased（P〈 0.05）. Conclusion Lobus pyramidalis glandulae thyroideae adenoma accompanied by cystic lesions has certain characteristics in the imaging, anatomic, and pathological examinations. Consummate preoperative examination,exairesis, pathological examination can eliminate the tumor and reduce misdiagnosis with lower recurrence rate and less influence on thyroid function.

关 键 词：甲状腺 腺瘤 锥体叶 囊性病变 手术 

分 类 号：R736.1[医药卫生—肿瘤]