精细化被膜解剖法在分化型甲状腺癌手术中的应用价值

发布时间：2018-03-03 12:02

本文选题：甲状腺肿瘤　切入点：甲状腺切除术　出处：《中国普通外科杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的:探讨精细化被膜解剖法在分化型甲状腺癌手术中的应用价值。方法:回顾2011年3月—2015年3月75例行全甲状腺切除+中央组淋巴结清扫术的分化型甲状腺癌患者资料,患者均采用精细化被膜解剖法对甲状旁腺的识别与原位保留,对于严重缺血或误切的甲状旁腺,术中及时进行自体移植。结果:75例患者中,46例术中确认并原位保留甲状旁腺4枚,其余原位保留2~3枚。手术后12h,部分患者出现口角及手足麻木、轻度抽搐,无1例患者出现呼吸困难、休克等严重并发症;术后1个月,血清钙2.0mmol/L18例,术后2~3个月,血清钙2.0mmol/L11例,术后4~6个月,患者血清钙均2.0mmol/L。术后随访16~18个月,患者血清钙2.0mmol/L,无临床低钙症状。结论:在分化型甲状腺癌患者手术中,运用精细化被膜解剖法,有助于精准识别甲状旁腺并最大可能的原位保留甲状旁腺及其功能。
[Abstract]:Objective: to evaluate the value of fine membrane dissection in the operation of differentiated thyroid carcinoma. Methods: from March 2011 to March 2015, 75 patients with differentiated thyroid carcinoma underwent total thyroidectomy and central lymph node dissection. The parathyroid gland was identified and preserved in situ by fine membrane dissection, and the parathyroid gland with severe ischemia or miscut was observed. Results in 46 of 75 cases, 4 parathyroid glands were confirmed and preserved in situ, and 3 parathyroid glands were preserved in the rest. 12 hours after operation, some of the patients developed spat and numbness of hands and feet, and mild convulsions. There were no severe complications such as dyspnea and shock in one patient, 18 cases of serum calcium 2.0 mmol / L, 2 ~ 3 months after operation, 11 cases of serum calcium 2.0 mmol / L, and 4 ~ 6 months after operation, all of them were followed up for 16 ~ 18 months. Conclusion: in patients with differentiated thyroid carcinoma, the use of fine membrane anatomy is helpful to identify the parathyroid gland and preserve the parathyroid gland and its function in situ.
【作者单位】：郑州市第一人民医院普通外科;郑州大学第一附属医院甲状腺外科;
【分类号】：R736.1

【相似文献】