不同术式治疗合并桥本甲状腺炎的甲状腺乳头状癌的临床观察  

Effect of different surgical procedures in patients with thyroid papillary carcinoma combined Hashimoto's thyroiditis

作　　者：区颖豪[1] 梁丽婷 陈晓[1] 黄灿东 

机构地区：[1]肇庆市第一人民医院普外科,肇庆526040 [2]肇庆市中心血站检验科,肇庆526020 [3]广西横县人民医院普外科,广西530300

出　　处：《广州医药》2016年第6期32-34,共3页Guangzhou Medical Journal

基　　金：广东省肇庆市科技局立项(201604030737)

摘　　要：目的探究在合并桥本甲状腺炎的甲状腺乳头状癌治疗过程中,应用不同手术方式对其进行治疗后的效果。方法选取2015年04月—2016年05月在我院进行手术治疗的87例单侧甲状腺乳头状癌合并桥本甲状腺炎患者,并将所有患者按照不同的手术方式分为两组,分别命为观察组、对照组。观察组44例患者选择患侧甲状腺腺叶+峡部切除的术式,对照组43例患者选择全甲状腺切除的术式。对比两组应用不同术式治疗后的甲状旁腺功能及甲状腺功能的变化,术中出血量、切口长度及手术时间。结果观察组的甲状旁腺功能低下率(0.00%)、甲状腺功能低下率(2.27%)以及切口长度(4.00±1.10)cm、术中出血量(33.60±8.30)m L、手术时间(130.73±34.67)min均低于对照组的甲状旁腺功能低下率(11.63%)、甲状腺功能低下率(97.67%)以及切口长度(9.70±2.33)cm、术中出血量(76.70±23.90)m L、手术时间(160.94±39.70)min,差异有统计学意义(P<0.05)。结论合并桥本甲状腺炎的甲状腺乳头状癌患者采用患侧甲状腺腺叶+峡部切除术的治疗效果显著,可有效降低甲状旁腺及甲状腺功能低下几率的发生,改善术中出血量、切口长度及手术时间相关指标。Objective To explore clinical efficacy of different surgical methods in treatment of papillary thyroid cancinoma combined Hashimoto＇s thyroiditis. Methods Eighty-seven patients of unilateral papillary thyroid carcinoma in patients with Hashimoto＇s thyroiditis who were treated in our hospital between April 2015 and May 2016 were divided into two groups according to surgical treatment methods,namely observation group and control group. Forty-four patients in the observation group received ipsilateral thyroid lobe ＋isthmus resection,while forty-three patients in the control group were given total thyroidectomy. Changes of parathyroid and thyroid functions,intraoperative blood loss,length of incision and operation time after different surgical procedures were compared. Results The hypoparathyroidism rate （0.00%）,hypothyroidism rate （2.27%）,and incision length （4.00 ±1.10）cm,blood loss （33.60 ±8.30）mL,operation time （130.73 ±34.67）min in the observation group were lower than those in the control group （1 1.63%）,（97.67%）,（9.70 ±2.33 ） cm,（76.70 ±23.90 ） mL, （160.94 ±39.70）min,the difference was statistically significant （P〈0.05）. Conclusion Ipsilateral thyroid lobe and isthmus resection shows obvious effect in treatment of papillary thyroid carcinoma with Hashimoto＇s thyroiditis,effectively reduces the incidence of parathyroid and thyroid dysfunction,improves intraoperative blood loss,length of incision and operation time.

关 键 词：桥本甲状腺炎 不同术式 甲状腺乳头状癌 

分 类 号：R736.1[医药卫生—肿瘤]