甲状腺癌术中甲状旁腺误切危险因素分析

发布时间：2018-04-16 22:26

本文选题：甲状腺癌 + 甲状旁腺　；参考：《中国实用外科杂志》2017年09期

【摘要】：目的分析甲状腺癌手术中甲状旁腺误切相关危险因素。方法回顾性分析2014-10-01—2015-10-01中国医学科学院北京协和医学院肿瘤医院头颈外科收治的1047例初治甲状腺乳头状癌病人资料,包括病人一般情况、病灶及手术情况、术中是否使用纳米碳等,按术后病理学检查是否有甲状旁腺分为两组,比较两组病例各因素差异。另以误切甲状旁腺所处病理标本位置分腺叶标本组、中央区标本组,比较术中是否应用纳米碳对两组位置甲状旁腺误切率的影响。结果术后病理学检查报告见甲状旁腺198例(占18.9%)。单因素分析提示男性、病灶侵犯被膜、颈部淋巴结清扫者有较高的甲状旁腺误切率,差异具有统计学意义。多因素分析提示男性、病灶侵犯被膜是甲状旁腺误切的独立危险因素。在不同位置甲状旁腺误切的比较中,应用纳米碳后对腺叶标本组、中央区标本组病例虽均具有减少甲状旁腺误切的作用,但差异仅对前者有统计学意义。结论甲状腺癌手术中,男性、病灶侵犯被膜、颈部淋巴结清扫是甲状旁腺误切的高危因素,应用纳米碳对邻近甲状腺腺体或位于腺体内的甲状旁腺有更好的保护效果。
[Abstract]:Objective to analyze the risk factors of parathyroid gland missection in thyroid carcinoma surgery.Methods the data of 1047 patients with papillary thyroid carcinoma treated in head and neck surgery, Beijing Union Medical College, Chinese Academy of Medical Sciences, 2014-10-01-2015-10-01, including general condition, lesion and operation were retrospectively analyzed.The patients were divided into two groups according to the pathological examination of parathyroid gland after operation, and the difference of factors between the two groups was compared.In addition, the pathological location of parathyroid gland was divided into two groups: the lobes group and the central region group. The effect of nano-carbon on the rate of parathyroid missection in the two groups was compared.Results 198 cases (18.9%) of parathyroid gland were found in pathological examination after operation.Univariate analysis showed that there was a higher rate of parathyroid missection in male patients with lesion invasion of the capsule and neck lymph node dissection, and the difference was statistically significant.Multivariate analysis showed that the lesion invasion was an independent risk factor for parathyroid gland missection in men.In the comparison of parathyroid gland missection in different locations, the central area standard group of parathyroid gland specimens treated with nano-carbon had the effect of reducing parathyroid gland missection, but the difference was statistically significant only for the former.Conclusion in thyroid cancer surgery, the male, the focus invades the capsule, the neck lymph node dissection is the high risk factor of parathyroid gland missection, the application of nano-carbon has better protective effect on the adjacent thyroid gland or the parathyroid gland located in the gland.
【作者单位】：国家癌症中心中国医学科学院北京协和医学院肿瘤医院头颈外科;
【分类号】：R736.1

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