资源描述：
《甲状腺肿瘤外科手术2228 例临床分析.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、中华耳鼻咽喉头颈外科杂志2005年4月第40卷第4期ChinJOtorhinolaryngolHeadNeckSurg,April2005,Vol40,No14·295··临床研究·甲状腺肿瘤外科手术2228例临床分析王家东邓星程金晓杰周川张淳谢明周佳青钱敏飞【摘要】目的探讨甲状腺肿瘤外科治疗效果,总结甲状腺肿瘤的诊疗经验。方法回顾性分析1992年—2004年间2228例甲状腺肿瘤(2072例甲状腺良性肿瘤,156例甲状腺癌)的临床资料及随访结果。结果2072例甲状腺良性肿瘤中,术后喉返神经损伤4例,永久性
2、喉返神经损伤率是011%,暂时性喉返神经损伤率为011%;55例复发行二次手术,复发率为216%。术后无甲状旁腺功能低下和出血。甲状腺癌156例,8例复发,3例死亡,直接法统计5年生存率为9515%(64/67),Kaplan2Meier法统计5年生存率为9810%。60例微小癌中无1例复发或转移,5年生存率为10010%。156例甲状腺癌中1例喉返神经损伤,发生率为016%,术后无出血和甲状旁腺功能低下。结论遵循甲状腺肿瘤正确外科治疗原则能有效降低甲状腺疾病患者手术并发症、复发率等,并改善预后。【关键词】
3、甲状腺肿瘤;甲状腺切除术;颈淋巴结清扫术;存活率;手术中并发症Clinicalresearchon2228casesofthyroidglandtumorsWANGJia2dong,DENGXing2cheng,JINXiao2jie,ZHOUChuan,ZHANGChun,XIEMing,ZHOUJia2qing,QIANMin2fei1DepartmentofOtorhinolaryngologyHeadandNeckSurgery,AffiliatedRenjiHospital,ShanghaiSec
4、ondUniversity,Shanghai200001,ChinaCorrespondingauthor:WANGJia2dong,Email:jiadongw@online1sh1cn【Abstract】ObjectiveTodiscussoutcomeofthyroidtumorpatientstreatedwithsurgery1MethodsTotalnumberofpatientswas22281Thesepatientsofthyroidtumorsfrom199222004(2072case
5、sofbenignthyroiddiseasesand156casesofthyroidcarcinoma)wererecruited1Theclinicalandfollow2updatumwereretrospectiveanalyzed1Results(1)Benignthyroidtumorswithnear2totalthyroidectomyincluding1761thyroidadenoma,207nodulargoiterand104Hashimotosthyroiditis,theinc
6、idenceofrecurrentlaryngealnerveparalysiswas012%,55cases(216%)receivedsecondarysurgery1Allthepatientshavenohypocalcemiaorhemorrhageafteroperation1(2)Eighty2onecasesofpapillarycarcinomaofthethyroid(>1cm)and60casesofmicrocarcinoma1Unilateralthyroidectomy,cont
7、ralateralnear2totalthyroidectomyandipsilateralmodifiedneckdissectionwereperformedinunilateralpapillarycarcinomaofthyroid1Amongthe9casesoffollicularcarcinomaofthyroid,7wereperformedofnear2totalthyroidectomywithoutneckdissection,otherswerethesameaspapillaryc
8、arcinoma1Bilateraltotalthyroidectomyandbilateralmodifiedneckdissectionwereperformedin2casesofthemedullarythyroidcancerand1caseoftheundifferentiatedthyroidcancer1Bydirectmethodthe52yearsurvivalwas9515%(64/67),
