甲状腺癌94例临床治疗分析

目的总结94例甲状腺癌临床诊治经验。方法回顾性分析94例甲状腺癌的临床资料。结果经病理诊断甲状腺癌94例,占同期甲状腺疾病的4·1%,术前误诊49例,误诊率为52·1%。根据病理结果采取不同的手术方式,其中再次手术40例,占42·6%。术后单侧喉返神经损伤2例,喉上神经损伤3例,甲状旁腺损伤2例,无手术死亡病例。结论术前注重病史及体格检查,并综合多种检查措施可提高诊断率。术前穿刺活检及快速冰冻切片可减少误诊率。再次手术的手术方式及颈淋巴结的清扫范围,均应根据患者的具体病情实施。

THE CLINICAL ANALYSES OF TREATMENT OF 94 PATIENTS WITH THYROID CARCINOMA

Objective To summarize experience of diagnosis and treatment of 94 patients with thyroid carcinoma. Methods Clinical data of 94 patients with thyroid carcinoma were retrospectively analyzed. Results Ninety-four thyroidal carcinomas (including 52 papillary carcinomas, 32 follicular carcinomas, 4 medullary carcinomas, 6 undifferentiated carcinomas) were pathologically diagnosed which accounts for 4.1% of all patients with thyroidal diseases, and 49 (52.1%) of them were misdiagnosed, and 22 of them had metastasis of neck lymph nodes. Operation procedures were taken according to pathological results. Forty (42.6%) of these patients were re-operated. Two patients appeared damage of unilateral recurrent laryngeal nerve, and 3 of them appeared damage of unilateral superior laryngeal nerve. Mortality rate of operation was 0. Conclusion Paying attentions to medical history and physical examination, and colligate different experimental examinations helps correct diagnosis. Puncture biopsy and frozen section helps to decrease misdiagnosis rate. Re-operation procedures and bounds of removing neck lymph nodes should be determined according to conditions of each patient.