甲状腺微小癌的外科诊疗分析

发布时间：2018-07-06 16:42

本文选题：分化型甲状腺微小癌 + 发病率　；参考：《内蒙古大学》2015年硕士论文

【摘要】：通过分析研究甲状腺微小癌的临床资料,探讨其临床特点以及行颈中央区淋巴结清扫的临床价值,从而为临床甲状腺微小癌诊断和治疗提供参考。对2011年1月一2014年12月我院住院患者中,通过手术病理活检结果显示甲状腺微小癌的117例患者的临床病例资料进行详细的、系统性的分析。主要结果有：(1)117例患者均行手术治疗,其中男性33例,女性84例,男女比例1：2.5；(2)本课题中,不论是总体发病高峰还是男女发病高峰均为40-49岁,其平均年龄约为40岁左右；(3)行近全切除术68例,单侧腺叶及峡部切除术34例,甲状腺全切术15例；(4)行颈部清扫术68例,VI区清扫33例,VI区+颈侧区清扫28例,双侧颈侧区清扫7例。根据以上分析,得出如下结论：(1)近年来甲状腺微小癌的发病率呈明显上升的趋势,女性的发病率明显高于男性。(2)甲状腺结节伴钙化对甲状腺癌的诊断有重要的提示作用,均应手术治疗。(3)甲状腺微小癌起病隐匿,术前诊断较困难,彩色超声是术前诊断甲状腺微小癌的主要检测方法。(4)手术是甲状腺微小癌的首选治疗方法,预后较好,手术方式的选择及患者年龄是甲状腺癌复发的重要影响因素。(5)甲状腺微小癌术前颈中央区淋巴结超声诊断提示可疑阳性的,在有效保留甲状旁腺和喉返神经的情况下,均需常规行颈中央区淋巴结清扫。对于中央区淋巴结超声提示阴性的,可在结合患者高危因素及患者要求的前提下建议患者行预防性颈中央区淋巴结清扫。
[Abstract]:By analyzing the clinical data of thyroid microcarcinoma and discussing its clinical characteristics and the clinical value of lymph node dissection in the central cervical region, this paper provides a reference for the diagnosis and treatment of thyroid microcarcinoma. The clinical data of 117 patients with thyroid microcarcinoma from January 2011 to December 2014 were analyzed in detail and systematically. The main results were as follows: (1) 117 patients were treated surgically, including 33 males and 84 females, the ratio of male to female was 1: 2.5. (2) in this study, both the overall peak of onset and the peak of incidence of male and female were 40-49 years old, the average age was about 40 years old. (3) Near-total excision was performed in 68 cases, unilateral lobectomy and isthmus resection in 34 cases, total thyroidectomy in 15 cases, neck dissection in 68 cases and neck dissection in 33 cases (28 cases), bilateral neck dissection in 7 cases. According to the above analysis, the following conclusions can be drawn: (1) the incidence of thyroid microcarcinoma is obviously increasing in recent years, and the incidence of female is obviously higher than that of male. (2) thyroid nodule with calcification has an important role in the diagnosis of thyroid carcinoma. All patients should be treated surgically. (3) thyroid microcarcinoma is occult and difficult to diagnose before operation. Color ultrasound is the main method to detect thyroid microcarcinoma before operation. (4) surgery is the first choice for the treatment of thyroid microcarcinoma, and the prognosis is good. The choice of surgical methods and the age of the patients were the important factors influencing the recurrence of thyroid carcinoma. (5) Ultrasonic diagnosis of cervical central lymph nodes in thyroid microcarcinoma before operation showed suspicious positive, while effectively preserving the parathyroid gland and recurrent laryngeal nerve. The lymph nodes of the central cervical region should be dissected routinely. For those with negative central lymph nodes, preventive cervical central lymph node dissection should be performed in combination with the high risk factors of patients and the requirements of patients.
【学位授予单位】：内蒙古大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R736.1

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