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目的 探讨原发性甲状腺功能亢进症 (甲亢 )合并甲状腺癌 (甲癌 )的诊治方法。方法 对 1993年 7月至 2 0 0 2年 3月 11例原发性甲亢合并甲癌临床资料进行回顾性分析。结果 发病率 1.6%。术前术中甲癌漏诊率 81.8%。 2例首次手术为甲状腺一侧腺叶全切加峡部切除加对侧腺叶次全切除 ,9例首次手术为甲状腺次全切除术。术后病理均为原发性甲亢合并甲癌 ,滤泡状腺癌 5例 ,乳头状腺癌 4例 ,混合癌 2例 ,无颈淋巴结转移。 7例行二次手术 ,3例有甲状腺残癌 ,残癌率 42 .9%。所有病例术后均长期给予甲状腺素片治疗。 10例生存良好 ,1例死亡。结论 原发性甲亢合并甲癌易漏诊 ,发现甲状腺结节应警惕合并甲癌可能性。合理的手术治疗 ,术后服用甲状腺素片 ,疗效较好
Objective To investigate the diagnosis and treatment of primary hyperthyroidism (Hyperthyroidism) with thyroid cancer (A). Methods From July 1993 to March 2002, 11 cases of primary hyperthyroidism complicated with carcinoma of the neck were retrospectively analyzed. The incidence of 1.6%. Preoperative intraoperative miscarriage rate of 81.8%. 2 cases of the first operation for the thyroid gland lobectomy with total isthmus resection and subtotal lobectomy, 9 cases of the first surgery for subtotal thyroidectomy. Postoperative pathology was primary hyperthyroidism with carcinoma, follicular adenocarcinoma in 5 cases, papillary adenocarcinoma in 4 cases, mixed carcinoma in 2 cases, no cervical lymph node metastasis. 7 cases of secondary surgery, 3 cases of thyroid cancer, residual cancer rate of 42.9%. All cases were given long-term thyroid hormone tablets treatment. Ten survived well and one died. Conclusions Primary hyperthyroidism complicated with carcinoma of the thyroid is easy to misdiagnosis. It is found that the thyroid nodules should be alert to the possibility of combined carcinoma of the thyroid. Reasonable surgical treatment, after taking thyroxine tablets, the effect is better