| 甲状腺全切治疗分化型甲状腺癌的临床意义和并发症分析 |
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| 引用本文： | 张滨,李福荣,冯江,连凌云,李小毅,牛福勇,侯建峰,李发智,艾剑锋. 甲状腺全切治疗分化型甲状腺癌的临床意义和并发症分析[J]. 陕西肿瘤医学, 2013, 0(9): 1967-1969 |
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| 作者姓名： | 张滨 李福荣 冯江 连凌云 李小毅 牛福勇 侯建峰 李发智 艾剑锋 |
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| 作者单位： | [1]延安大学医学院第二附属医院榆林市第一医院普外科,陕西榆林719000 [2]北京协和医院基本外科,北京100730 |
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| 摘 要： | 目的：探讨甲状腺全切除术治疗分化型甲状腺癌的临床意义及相关风险.方法：对2007年1月至2011年6月我院行甲状腺全切术及甲状腺次全切或近全切患者的临床资料进行回顾性分析,92例患者实施甲状腺全切手术为全切组；86例患者实施次全切或近全切术为双叶组,20例患者复发后二次手术行全切术为复发组,分析患者术后甲状旁腺功能和喉返神经损伤情况.结果：甲状腺全切组术后甲状旁腺功能减退发生率明显高于双叶组（P＜0.05）,而复发组则明显高于全切组（P＜0.05）；甲状腺全切组术后喉返神经损伤发生率则与另外两组无显著性差异（P＞0.05）.全切组中有腺体外侵犯组的甲状旁腺功能减退及喉返神经损伤发生率明显高于无腺体外侵犯组（P＜0.05）,而根治性颈清组并发症发生率与中央区颈清组无显著统计学差异（P＞0.05）.结论：甲状腺全切除术增加甲状旁腺功能减退发生率,而不增加喉返神经损伤的发生率；复发二次手术会增加甲状旁腺功能减退的发生,对喉返神经损伤的发生无显著影响；存在腺体外侵是增加并发症的危险因素,而是否行根治性颈清术不增加并发症的发生.因此在临床工作中应该有选择的施行甲状腺全切除手术.
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| 关 键 词： | 甲状腺全切术 分化型甲状腺癌 并发症 |
Clinical significance and risk of total thyroidectomy in differentiated thyroid carcinoma |
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| Affiliation: | Zhang Bin(Second Affiliated Hospital of Medical School, Yan＇an University, First Hospital of Yulin, Shaanxi Yulin 719000, China) Li Furong(Second Affiliated Hospital of Medical School, Yan＇an University, First Hospital of Yulin, Shaanxi Yulin 719000, China) Feng Jiang(Second Affiliated Hospital of Medical School, Yan＇an University, First Hospital of Yulin, Shaanxi Yulin 719000, China) Lian Lingyun(Second Affiliated Hospital of Medical School, Yan＇an University, First Hospital of Yulin, Shaanxi Yulin 719000, China) Li Xiaoyi(General Surgery of Peking Union Medical College Hospital,Beijing 100730, China) Niu Fuyong(Second Affiliated Hospital of Medical School, Yan＇an University, First Hospital of Yulin, Shaanxi Yulin 719000, China) Hou Jianfeng(Second Affiliated Hospital of Medical School, Yan＇an University, First Hospital of Yulin, Shaanxi Yulin 719000, China) |
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| Abstract: | Objective：To investigate clinical significance and risk of total thyroidectomy in differentiated thyroid carcinoma.Methods：Clinical data of patients who underwent total thyroidectomy （total thyroidectomy group,92 cases）,sub-total or near-total thyroidectomy surgery （two-lobe group,86 cases） and secondary surgery for recurrence （recurrent group,20 cases） for thyroid carcinoma were retrospectively analyzed to identify the incidences of complications,recurrent laryngeal nerve paralysis （RNLP） and secondary hypoparathyroidism.Results：The postoperative hypoparathyroidism incidence of the total thyroidectomy group was significantly higher than the two-lobe group （P ＜ 0.05）,and the recurrent group was significantly higher than the total thyroidectomy group （P ＜ 0.05）.The postoperative recurrent laryngeal nerve paralysis incidence of the total thyroidectomy group hadn＇t significantly statistical differences with other two groups （P ＞ 0.05）.The postoperative hypoparathyroidism and recurrent laryngeal nerve paralysis incidence of the extraglandular invasion group in the total thyroidectomy group was significantly higher than the interglandular group （P ＜ 0.05）,but the complication incidence between dissection of neck group and no dissection of neck group hadn＇t significant difference （P ＞ 0.05）.Condusion：Total thyroidectomy increases secondary hypoparathyroidism incidence,without increasing the incidence of recurrent laryngeal nerve injury.Second surgery after recurrence increases the occurrence of hypoparathyroidism,but no significant effect on the incidence of recurrent laryngeal nerve injury.The presence of extraglandular invasion is a risk factor for increased complications,and whether undergoing dissection of neck does not increase the incidence of complications.Total thyroidectomy should be performed in selected patients. |
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| Keywords: | total thyroidectomy differentiated thyroid carcinoma complications |
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