【摘要】 目的:探究双侧甲状腺癌患者应用全甲状腺切除术(TT)治疗的近远期疗效。方法:回顾性分析某院行TT术式治疗(观察组)和行近全切术式治疗(对照组)双侧甲状腺癌患者各48例的临床资料。比较2组术前及术后第1天、第5天、1年时基础甲状旁腺激素水平(iPTH)水平差异,并记录2组近期手术并发症发生情况(暂时性喉返神经麻痹、甲状旁腺功能减退、术后继发性出血)及远期预后情况(永久性甲状旁腺功能损伤、永久性喉返神经损伤、癌转移、癌复发)的差异。结果:2组患者术前及术后第1天、第5天的外周血iPTH水平比较,差异无统计学意义(P>0.05),但观察组术后1年时外周血iPTH水平高于对照组(P<0.05);观察组外周血iPTH水平,术后第1天<术后第5天<术前(P<0.05),但术前与术后1年时比较,差异无统计学意义(P>0.05);对照组外周血iPTH水平,术后第1天<术后第5天<术后1年<术前(P<0.05)。2组近期手术并发症发生率比较,差异无统计学意义(P>0.05)。观察组永久性甲状旁腺功能损伤、永久性喉返神经损伤、癌转移、癌复发发生率均低于对照组(P<0.05)。结论:TT术式应用于双侧甲状腺癌患者治疗中,效果较好,可避免近期并发症发生,也能改善患者远期预后情况,对提高患者生存质量有积极意义。更多还原

【Abstract】 Objective: To explore the short-term and long-term efficacy of total thyroidectomy(TT) in patients with bilateral thyroid cancer. Methods: Clinical data of 48 patients with bilateral thyroid cancer treated with TT(observation group) and subtotal thyroidectomy(control group) in a hospital were retrospectively analyzed. The basic parathyroid hormone(i PTH) level was compared between the two groups before operation and at 1 d,5 d,1 year after operation,and the recent surgical complications(temporally recurrent laryngeal nerve palsy,hypoparathyroidism,and postoperative secondary hemorrhage) and long-term prognosis(permanent parathyroid function injury,permanent recurrent laryngeal nerve injury,cancer metastasis,and cancer recurrence) were recorded in the two groups. Results: There was no statistically significant difference in peripheral blood i PTH level before operation and at 1 d and 5 d after operation between the two groups(P < 0. 05),but the peripheral blood i PTH level in the observation group at 1 year after operation was significantly higher than that in the control group(P < 0. 05). The peripheral blood i PTH level in the observation group showed a trend of 1 d after operation < 5 d after operation < before operation(P < 0. 05),but there was no significant difference between before operation and at 1 year after operation(P > 0. 05). The peripheral blood i PTH level in the control group manifested a tendency of 1 d after operation < 5 d after operation < 1 year after operation < before operation(P < 0. 05). There was no significant difference between the two groups in the incidence rate of recent surgical complications(P > 0. 05). The incidence rates of permanent parathyroid function injury,permanent recurrent laryngeal nerve injury,cancer metastasis and cancer recurrence in the observation group were lower than those in the control group(P < 0. 05). Conclusion: TT in the treatment of bilateral thyroid cancer can have good effects,and can avoid short-term complications and improve the long-term prognosis of patients,and it has a positive meaning in improving the quality of life for patients.更多还原