中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
23期
6-8
,共3页
周晓聪%叶正亮%叶英海%周宏%倪耀忠
週曉聰%葉正亮%葉英海%週宏%倪耀忠
주효총%협정량%협영해%주굉%예요충
甲状腺肿瘤%甲状腺切除术%颈淋巴结清扫术
甲狀腺腫瘤%甲狀腺切除術%頸淋巴結清掃術
갑상선종류%갑상선절제술%경림파결청소술
Thyroid neoplasms%Thyroidectomy%Neck dissection
目的 探讨双侧甲状腺乳头状癌的手术治疗方法.方法 回顾性分析55例双侧甲状腺乳头状癌患者的临床资料.行双侧甲状腺全切除术52例,行一侧腺叶全切除+对侧近全切除术3例.结果 双侧功能性颈淋巴结清扫术中,5例均见双侧颈淋巴结转移,阳性率为100.0%(5/5);单侧功能性颈淋巴结清扫术中,9例见颈淋巴结转移,阳性率为81.8%(9/11).双侧中央区淋巴结清扫术中,1例见中央区淋巴结转移,阳性率为25.0%(1/4);单侧中央区淋巴结清扫术中,14例见中央区淋巴结转移,阳性率为66.7%(14/21).术后随访0.5～12.9年,53例无瘤生存,2例伴远处转移者也取得良好效果.结论 双侧甲状腺乳头状癌为多发癌,宜行双侧甲状腺全切除术.应结合患者的肿瘤分期,考虑是否行颈淋巴结清扫术.
目的 探討雙側甲狀腺乳頭狀癌的手術治療方法.方法 迴顧性分析55例雙側甲狀腺乳頭狀癌患者的臨床資料.行雙側甲狀腺全切除術52例,行一側腺葉全切除+對側近全切除術3例.結果 雙側功能性頸淋巴結清掃術中,5例均見雙側頸淋巴結轉移,暘性率為100.0%(5/5);單側功能性頸淋巴結清掃術中,9例見頸淋巴結轉移,暘性率為81.8%(9/11).雙側中央區淋巴結清掃術中,1例見中央區淋巴結轉移,暘性率為25.0%(1/4);單側中央區淋巴結清掃術中,14例見中央區淋巴結轉移,暘性率為66.7%(14/21).術後隨訪0.5～12.9年,53例無瘤生存,2例伴遠處轉移者也取得良好效果.結論 雙側甲狀腺乳頭狀癌為多髮癌,宜行雙側甲狀腺全切除術.應結閤患者的腫瘤分期,攷慮是否行頸淋巴結清掃術.
목적 탐토쌍측갑상선유두상암적수술치료방법.방법 회고성분석55례쌍측갑상선유두상암환자적림상자료.행쌍측갑상선전절제술52례,행일측선협전절제+대측근전절제술3례.결과 쌍측공능성경림파결청소술중,5례균견쌍측경림파결전이,양성솔위100.0%(5/5);단측공능성경림파결청소술중,9례견경림파결전이,양성솔위81.8%(9/11).쌍측중앙구림파결청소술중,1례견중앙구림파결전이,양성솔위25.0%(1/4);단측중앙구림파결청소술중,14례견중앙구림파결전이,양성솔위66.7%(14/21).술후수방0.5～12.9년,53례무류생존,2례반원처전이자야취득량호효과.결론 쌍측갑상선유두상암위다발암,의행쌍측갑상선전절제술.응결합환자적종류분기,고필시부행경림파결청소술.
Objective To explore surgical management of bilateral thyroid papillary carcinoma. Methods The clinical data of 55 patients with bilateral thyroid papillary carcinoma were analyzed retrospectively. Among the 55 patients, total thyroidectomy was performed in 52 cases, total affected lobectomy plus isthmus and opposite near total lobectomy thyroidectomy was performed in 3 cases. Results Among the cases of bilateral functional neck lymph node dissection ,5 cases were all of bilateral neck lymph node metastasis, the positive rate was 100.0%(5/5);, among the cases of unilateral functional neck lymph node dissection,9 cases were found neck lymph node metastasis,the positive rate was 81.8%(9/11); among the cases of bilateral central region lymph node dissection, 1 case was of central region lymph node metastasis, the positive rate was 25.0% (1/4); among the cases of unilateral central region lymph node dissection, 14 cases were of central region lymph node metastasis, the positive rate was 66.7%(14/21). Fifty-three cases were tumor free survival, 2 cases accompanied distant metastasis also gained good effect Conclusions Total thyroidectomy should be performed for bilateral thyroid papillary carcinoma because of its characteristics of multiple tumors. It is considered that whether the neck lymph node dissection should be done depends on the stage of the tumor.
