桥本氏甲状腺炎合并甲状腺乳头状癌的手术治疗效果观察  

Surgical Treatment of Hashimoto's Thyroiditis Complicated With Papillary Thyroid Carcinoma

作　　者：张旭旭[1] 管小青[1] 顾书成 吴骥[1] 郑向欣[1] 邱兴[1] 陆柏林[1] ZHANG Xuxu;GUAN Xiaoqing;GU Shucheng;WU Ji;ZHENG Xiangxin;QIU Xing;LU Bailin(Department of Breast Surgery,Suqian City People＇s Hospital of Nanjing Gulou Hospital Group,Suqian Jiangsu 223800,China)

机构地区：[1]南京鼓楼医院集团宿迁市人民医院甲乳外科,江苏宿迁223800

出　　处：《中国继续医学教育》2018年第32期100-102,共3页China Continuing Medical Education

摘　　要：目的分析采用手术治疗桥本氏甲状腺炎合并甲状腺乳头状癌的临床效果。方法选取我院2014年1月—2015年12月收治的桥本氏甲状腺炎合并甲状腺乳头状癌患者60例作为研究对象。所有患者均实施手术治疗,并在手术过程中实施冰冻切片,术后石蜡病理亦证实为桥本氏甲状腺炎合并甲状腺乳头状癌,手术后终生服用左旋甲状腺素片。结果 60例患者中,49例患者为单侧桥本氏甲状腺炎(桥本氏病合并单侧乳头状癌),11例患者为对侧桥本甲状腺炎合并甲状腺乳头癌(桥本氏病合并双侧乳头状癌)。术后出现4例低钙血症患者,有12例Ⅲ期患者后续行^(131)Ⅰ治疗;2年随访患者术后恢复良好,仅有2例患者需要再次进行手术。结论针对于桥本氏甲状腺炎合并甲状腺乳头状癌的患者,手术治疗效果最理想,但是要根据患者的病变程度、淋巴结转移情况等相关因素选择合适的手术方式。Objective To analyze the clinical effect of surgical treatment of Hashimoto＇s thyroiditis combined with papillary thyroid carcinoma. Methods 60 cases of patients with Hashimoto＇s thyroiditis complicated with papillary thyroid carcinoma admitted to our hospital from January 2014 to December 2015 were selected as study subjects. All patients underwent surgical treatment and frozen section during the operation. The postoperative paraffin pathology also confirmed Hashimoto＇s thyroiditis complicated with papillary thyroid carcinoma. Levothyroid tablets were taken for life after operation. Results Of the 60 patients, 49 patients had unilateral Hashimoto＇s thyroiditis （Hashimoto＇s disease with unilateral papillary carcinoma） and 11 patients had contralateral Hashimoto＇s thyroiditis with thyroid papillary carcinoma （Hashimoto＇s disease with bilateral papillary carcinoma）. Postoperative hypocalcemia occurred in 4 patients, and 12 patients in stage Ⅲ were followed up for 131I treatment. After 2 years of follow-up, patients recovered well, and only 2 patients needed surgery again. Conclusion For Hashimoto＇s thyroiditis complicated with thyroid papillary carcinoma, surgical treatment is the best, but the appropriate surgical method should be selected according to the degree of disease, lymph node metastasis and other related factors.

关 键 词：桥本甲状腺炎 甲状腺癌 手术治疗 左旋甲状腺素片 淋巴结转移 临床效果 

分 类 号：R736[医药卫生—肿瘤]