中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2010年
3期
224-226
,共3页
甲状腺炎,自身免疫性%甲状腺肿瘤%外科手术
甲狀腺炎,自身免疫性%甲狀腺腫瘤%外科手術
갑상선염,자신면역성%갑상선종류%외과수술
Thyroiditis,autoimmune%Thyroid neoplasms%Surgical procedures,operative
目的 探讨桥本病合并甲状腺癌的诊断和治疗方法.方法 回顾分析74例桥本病合并甲状腺癌的临床资料.结果 2002年1月-2009年8月共收治252例桥本病,其中74例为桥本病合并甲状腺癌,均为乳头状癌,其中56例TGAb升高,68例MeAb升高,74例TPOAb升高.手术行患侧甲状腺全切除、峡部切除加对侧次全切除术45例,双侧甲状腺近全切除术1例(峡部癌).26例微小癌行甲状腺次全切除术或一侧腺叶全切除,2例双侧癌行双侧甲状腺全切除.所有病例同时行中央区淋巴结清扫,中央区淋巴结转移率20/74(27%).10例因患侧颈淋巴结转移行一侧颈部淋巴结改良清扫术.69例获得随访,随访时间1个月-7年,中位随访时间29个月.4例患者因发生一侧颈淋巴结转移而再次入院行改良颈淋巴清扫术. 结论'TGAb、McAb、B超、FNAB对术前诊断桥本病合并甲状腺癌有重要价值,手术应按甲状腺癌根治原则进行.
目的 探討橋本病閤併甲狀腺癌的診斷和治療方法.方法 迴顧分析74例橋本病閤併甲狀腺癌的臨床資料.結果 2002年1月-2009年8月共收治252例橋本病,其中74例為橋本病閤併甲狀腺癌,均為乳頭狀癌,其中56例TGAb升高,68例MeAb升高,74例TPOAb升高.手術行患側甲狀腺全切除、峽部切除加對側次全切除術45例,雙側甲狀腺近全切除術1例(峽部癌).26例微小癌行甲狀腺次全切除術或一側腺葉全切除,2例雙側癌行雙側甲狀腺全切除.所有病例同時行中央區淋巴結清掃,中央區淋巴結轉移率20/74(27%).10例因患側頸淋巴結轉移行一側頸部淋巴結改良清掃術.69例穫得隨訪,隨訪時間1箇月-7年,中位隨訪時間29箇月.4例患者因髮生一側頸淋巴結轉移而再次入院行改良頸淋巴清掃術. 結論'TGAb、McAb、B超、FNAB對術前診斷橋本病閤併甲狀腺癌有重要價值,手術應按甲狀腺癌根治原則進行.
목적 탐토교본병합병갑상선암적진단화치료방법.방법 회고분석74례교본병합병갑상선암적림상자료.결과 2002년1월-2009년8월공수치252례교본병,기중74례위교본병합병갑상선암,균위유두상암,기중56례TGAb승고,68례MeAb승고,74례TPOAb승고.수술행환측갑상선전절제、협부절제가대측차전절제술45례,쌍측갑상선근전절제술1례(협부암).26례미소암행갑상선차전절제술혹일측선협전절제,2례쌍측암행쌍측갑상선전절제.소유병례동시행중앙구림파결청소,중앙구림파결전이솔20/74(27%).10례인환측경림파결전이행일측경부림파결개량청소술.69례획득수방,수방시간1개월-7년,중위수방시간29개월.4례환자인발생일측경림파결전이이재차입원행개량경림파청소술. 결론'TGAb、McAb、B초、FNAB대술전진단교본병합병갑상선암유중요개치,수술응안갑상선암근치원칙진행.
Objective To investigate the diagnosis and treatment of Hashimoto's diseaseconcomitant with thyroid carcinoma. Methods Clinical data of 74 cages of thyroid carcinoma occuring on the background of Hashimoto's disease were retrospectively analyzed. Results All cases were papillary carcinoma pathologically.The serum TGAb and McAb level elevated in 56 and 68 cases,respectively.While TPOAB level was all elevated.45 cages underwent unilateral thyroideetomy and contralateral subtotal thyroidectomy,1 case did bilateral near total thyroidectomy,26 cases did unilateral thyroidectomy.and 2 cases with bilateral thyroidectomy.All cases underwent combined central region lymph nodes dissection(positive rate was 27%,20/74),10 cases underwent modied lymph node resection.69 cases were followed up rangins from 1 month to 7 years,with median length of 29 months.4 cases were re-admired for modified lymph nodes resection. Conclusion TGAb、McAb、FNAB and ultrasound is the main procedure forscreening Hashimoto's disese accompanied with thyroid carcinoma preoperatively.Radical thyroideetomy iS the therapy of choice.
