双侧分化型甲状腺癌19例治疗分析

目的 探讨双侧分化型甲状腺癌治疗方法及并发症预防。方法 回顾性分析1998年3月～2008年4月在南昌大学二附院治疗的19例双侧分化型甲状腺癌患者的临床病理资料，包括患者年龄、病理类型、有无淋巴及远处转移、治疗方案、术后并发症及生存期等。根据随访结果进行疗效及预后分析。结果 19例的患者均行同期双侧甲状腺全切除术，其中15例行常规双侧中央组淋巴结清扫，4例因术前CT发现单侧淋巴结转移行改良颈淋巴结清扫术。15例无瘤生存，3例术后复发，目前带瘤生存，1例伴肺转移者术后已3年，目前健在。术后10例患者出现暂时性有症状性甲状旁腺机能减退，全组未出现永久性甲状旁腺机能减退和喉返神经麻痹。 结论 双侧分化型甲状腺癌行双测甲状腺叶全切除术疗效确切，术中重视甲状旁腺及喉返神经解剖，可有效避免永久性甲状旁腺功能低下。

Total Thyroidectomy Conducted with 19 Bilateral Thyroid Carcinoma

【Abstract】 Objective To investigate the surgical treatment and complication of bilateral thyroid carcinoma (BTC). Methods　A retrospective review of 19 BTC patients primarily treated in our hospital from March 1998 to April 2008 was conducted. Data were collected including age, the cell type of primary cancer, the presence of lymph nodes metastasis, the methods of treatment, and complication of the treatment. Results There was no operative death in this series. All cases were treated with total thyroidectomy, Central region lymph nodes were resected in 15 cases, and additional unilateral functional lymph nodes resection was performed in 4 cases. All apatients were followed up, with tumor-free survival in 15 cases, and cervical lymph nodes metastasis in 3 cases, 1 patient with lung metastasis treated by I131 Radiation Therapy after operation 3 years ago survival now. 10 patients required intravenous calcium supplementation postoperation, there was not a single case permanence hypoparathyriodism and ecurrent nerve paralys duiing follow-up.Conlusion The effect is definite for BTC patients those was conducted total thyroidectomy. At the same time, total thyroidectomy is very safe and it doesn’t increase the occurrence of complications .