手术治疗分化型甲状腺癌合并淋巴细胞性甲状腺炎的临床疗效分析

Clinical Effect Analysis of Surgical Therapy In the Treatment of Differentiated Thyroid Carcinoma Complicated with Lymphoid Thyroiditis

目的:讨论手术治疗分化型甲状腺癌合并淋巴细胞性甲状腺炎的临床疗效。方法:选取2014年1月~2016年10月于某院收治的80例分化型甲状腺癌合并淋巴细胞性甲状腺炎患者,所有患者均实施甲状腺切除术联合区域性颈部淋巴结廓清术,观察患者的手术治疗效果、甲状旁腺功能情况。结果:80例患者经手术治疗后,平均手术操作时间为(126.3±30.7)min、平均术中出血量(22.2±10.2)ml、平均术后住院时间(3.4±1.1)d,治疗总有效率为96.25%(77/100);3例声音嘶哑,2例手足抽搐,2例呼吸困难,1例甲状腺危象现象,所有不良并发症经及时干预处理后均得以纠正。随访3年后,80例患者均未出现死亡以及病情复发现象,仅有1例患者出现颈部淋巴结转移情况,经再次手术治疗后已恢复。80例患者术后的血清PTH水平及血钙水平均明显低于对照组,P<0.05。结论:手术治疗分化型甲状腺癌合并淋巴细胞性甲状腺炎的临床疗效显著,可有效降低该病症复发率,值得推广。

Objective:To discuss the clinical effect of surgical therapy in the treatment of differentiated thyroid carcinoma complicated with lymphoid thyroiditis.Methods:80 patients with differentiated thyroid cancer complicated with lymphocytic thyroiditis admitted to a hospital from January 2014 to October 2016 were selected.All patients underwent thyroidectomy combined with regional cervical lymph node clearance.The effect of surgical treatment and the function of parathyroid gland were observed.Results:After surgical treatment,the average operation time of 80 patients was(126.3±30.7)min,and the average intraoperative blood loss was(22.2±10.2)ml,the average postoperative hospitalization time was(3.4±1.1)d.The total effective rate was 96.25%(77/100).There were 3 cases of hoarseness,2 cases of hand and foot convul-sions,2 cases of dyspnea and 1 case of thyroid crisis.All the adverse complications were corrected after timely intervention.After 3 years of follow-up,80 patients had no death and recurrence,only 1 patient had cervical lymph node metastasis,and recovered after reoperation.The levels of serum PTH and serum calcium in 80 patients were significantly lower than those in the control group(P<0.05).Conclusion:The clinical effect of surgical therapy in the treatment of differentiated thyroid gland cancer complicated with lymphoid thyroiditis is remarkable,which can effectively reduce the recurrence rate of the disease and is worth popularizing.