【摘要】 目的探讨甲状腺癌的诊断、治疗以及手术并发症的防治等。方法对1990年3月—2006年7月收治的487例甲状腺癌手术治疗的临床资料进行回顾性分析。结果术前和术中诊断甲状腺癌分别为279例(57.3%)和162例(33.3%),术后确诊46例(9.4%);再次手术140例(28.7%),发现残癌79例(56.4%);487例手术患者无1例院内死亡,17例术后出现短暂性声嘶,2例永久性声嘶,14例出现低钙抽搐或肢端麻木。413例患者获随访,其中颈部淋巴结复发者33例,局部复发者24例,远处转移者17例。分化型甲状腺癌,髓样癌和未分化癌术后5年生存率分别为99.8%,95.8%和87.0%。结论甲状腺结节伴钙化者应怀疑甲状腺癌可能,术中冷冻快速切片有助于甲状腺癌的诊断和术式的选择。应充分重视首次手术,术中应常规显露喉返神经。术后患者坚持终生服用甲状腺素片有助于预防复发和转移。更多还原

【Abstract】 Objective To investigate the diagnosis and treatment of thyroid carcinoma,and prevention of surgical complications.Methods Clinical data of 487 cases of thyroid carcinoma in our hospital from March 1990 to July 2006 were analyzed retrospectively.Results Among them,279(57.3%) and 162(33.3%) patients were diagnosed before and during operation respectively,and 46 patients were diagnosed after operation.Reoperation was performed in 140 patients(28.7%) and residual carcinoma was found in 79 patients(56.4%).No hospital deaths occurred in the 487 cases after operation.A total of 17 cases showed temporary vocal cord paralysis,2 cases showed permanent vocal cord paralysis,and 14 cases had convulsion or limb numbness due to hypocalcemia.Follow-up of 413 cases showed cervical lymph node tumor recurrence in 33 patients,local tumor recurrence in 24 patients and remote metastasis in 17 patients.The 5-year survival rate after operation of differentiated,medullary and undifferentiated thyroid carcinoma was 99.8%,95.8% and 87.0%,respectively.Conclusions The thyroid nodule with calcification should be considered to be thyroid carcinoma,and intra-operative frozen section is helpful for the diagnosis and the choice of operative method.The first thyroid operation should not be taken lightly.Patients should take thyroxine tablets for prophylaxis of tumor recurrence and metastasis.更多还原