甲状腺微小癌的诊治分析79例

Diagnosis and treatment of thyroid microcarcinoma in 79 cases

目的探讨甲状腺微小癌(TMC)的临床特征、术前诊断、手术方式。方法回顾性分析79例行手术治疗的甲状腺微小癌的临床资料。结果全组患者均痊愈出院,无术中、术后发生严重并发症死亡。发生暂时性喉返神经损伤致声音嘶哑4例(5.0%),无永久性声音嘶哑;暂时性甲状旁腺功能不全6例(7.6%);永久性甲状旁腺功能不全1例(0.6%);术后淋巴漏2例(2.5%);术后出血再手术1例(1.3%);术后随访复发0例;结论甲状腺微小癌具有其典型特征,高频超声检查准确、可靠,个体化选择手术切除范围及淋巴结清扫范围,仅此结论可达到较好治疗效果。

Objective To explore the clinical features,preoperative diagnosis and surgical procedure of thyroid microcarcinoma（TMC）. Methods Clinical data about 79 patients with TMC was retrospectively analyzed. Results：All patients were recovered anddischarged with no intraoperative and postoperative complications. Temporary laryngeal recurrent nerve injury induced hoarse occurredin 4 cases（5.0%）. But there were no permanent hoarse;Temporary parathyroid dysfunction were found in 6 cases（7.6%）;Perma-nent parathyroid dysfunction existed in 1 case（0.6%）. There were 2 cases who got postoperative lymphatic leakage（2.5%）. Postopera-tive bleeding and re-operation occurred in 1 case（1.3%）;There was no recurrence in postoperative follow-up;Conclusion：TMChas it＇s typical characteristics. High frequency ultrasound are accurate and reliable to diagnose this disease,Individualization on surgi-cal scope and lymph node cleaning scope can achieve better therapeutic effect.