本文選題：分化型甲狀腺微小癌 + 發(fā)病率��； 參考：《內(nèi)蒙古大學(xué)》2015年碩士論文

【摘要】：通過分析研究甲狀腺微小癌的臨床資料,探討其臨床特點(diǎn)以及行頸中央?yún)^(qū)淋巴結(jié)清掃的臨床價(jià)值,從而為臨床甲狀腺微小癌診斷和治療提供參考。對(duì)2011年1月一2014年12月我院住院患者中,通過手術(shù)病理活檢結(jié)果顯示甲狀腺微小癌的117例患者的臨床病例資料進(jìn)行詳細(xì)的、系統(tǒng)性的分析。主要結(jié)果有：(1)117例患者均行手術(shù)治療,其中男性33例,女性84例,男女比例1：2.5；(2)本課題中,不論是總體發(fā)病高峰還是男女發(fā)病高峰均為40-49歲,其平均年齡約為40歲左右；(3)行近全切除術(shù)68例,單側(cè)腺葉及峽部切除術(shù)34例,甲狀腺全切術(shù)15例；(4)行頸部清掃術(shù)68例,VI區(qū)清掃33例,VI區(qū)+頸側(cè)區(qū)清掃28例,雙側(cè)頸側(cè)區(qū)清掃7例。根據(jù)以上分析,得出如下結(jié)論：(1)近年來甲狀腺微小癌的發(fā)病率呈明顯上升的趨勢(shì),女性的發(fā)病率明顯高于男性。(2)甲狀腺結(jié)節(jié)伴鈣化對(duì)甲狀腺癌的診斷有重要的提示作用,均應(yīng)手術(shù)治療。(3)甲狀腺微小癌起病隱匿,術(shù)前診斷較困難,彩色超聲是術(shù)前診斷甲狀腺微小癌的主要檢測(cè)方法。(4)手術(shù)是甲狀腺微小癌的首選治療方法,預(yù)后較好,手術(shù)方式的選擇及患者年齡是甲狀腺癌復(fù)發(fā)的重要影響因素。(5)甲狀腺微小癌術(shù)前頸中央?yún)^(qū)淋巴結(jié)超聲診斷提示可疑陽性的,在有效保留甲狀旁腺和喉返神經(jīng)的情況下,均需常規(guī)行頸中央?yún)^(qū)淋巴結(jié)清掃。對(duì)于中央?yún)^(qū)淋巴結(jié)超聲提示陰性的,可在結(jié)合患者高危因素及患者要求的前提下建議患者行預(yù)防性頸中央?yún)^(qū)淋巴結(jié)清掃。
[Abstract]:By analyzing the clinical data of thyroid microcarcinoma and discussing its clinical characteristics and the clinical value of lymph node dissection in the central cervical region, this paper provides a reference for the diagnosis and treatment of thyroid microcarcinoma. The clinical data of 117 patients with thyroid microcarcinoma from January 2011 to December 2014 were analyzed in detail and systematically. The main results were as follows: (1) 117 patients were treated surgically, including 33 males and 84 females, the ratio of male to female was 1: 2.5. (2) in this study, both the overall peak of onset and the peak of incidence of male and female were 40-49 years old, the average age was about 40 years old. (3) Near-total excision was performed in 68 cases, unilateral lobectomy and isthmus resection in 34 cases, total thyroidectomy in 15 cases, neck dissection in 68 cases and neck dissection in 33 cases (28 cases), bilateral neck dissection in 7 cases. According to the above analysis, the following conclusions can be drawn: (1) the incidence of thyroid microcarcinoma is obviously increasing in recent years, and the incidence of female is obviously higher than that of male. (2) thyroid nodule with calcification has an important role in the diagnosis of thyroid carcinoma. All patients should be treated surgically. (3) thyroid microcarcinoma is occult and difficult to diagnose before operation. Color ultrasound is the main method to detect thyroid microcarcinoma before operation. (4) surgery is the first choice for the treatment of thyroid microcarcinoma, and the prognosis is good. The choice of surgical methods and the age of the patients were the important factors influencing the recurrence of thyroid carcinoma. (5) Ultrasonic diagnosis of cervical central lymph nodes in thyroid microcarcinoma before operation showed suspicious positive, while effectively preserving the parathyroid gland and recurrent laryngeal nerve. The lymph nodes of the central cervical region should be dissected routinely. For those with negative central lymph nodes, preventive cervical central lymph node dissection should be performed in combination with the high risk factors of patients and the requirements of patients.
【學(xué)位授予單位】：內(nèi)蒙古大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R736.1

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