摘要
目的探讨甲状腺癌误诊原因、对策及再手术的相关问题。方法分析77例甲状腺癌误诊原因及再手术效果。结果77例术前均仅依靠体格及超声检查做出诊断致误诊。71例外院行初次手术均未行冰冻切片致误诊；本院误诊6例中2例未行冰冻切片，2例冰冻切片误诊为良性腺瘤，2例当时无法定性延迟诊断。77例均再手术治疗。术前临床检查诊断癌灶残留符合率为71．4％；术后病理证实35例癌残留，残留率为45．45％；术前临床检查提示淋巴结转移符合率为80％；60例行区域性或改良性颈淋巴结清扫术，病理证实40例有转移；3例术后近期出现低钙血症，经治疗后恢复正常；所有患者术后随访3～41个月，无1例复发。结论术前诊断手段单一和术中未行冰冻切片是误诊的主要原因。对误诊误治的甲状腺癌应及时给予再手术治疗，根据个体情况选择合理术式，其再手术效果令人满意。
Objective To explore the reason of misdiagnosis and discuss the reoperation in thyroid carcinoma. Methods The data of 77 patients that had reoperation because of misdiagnosis were analyzed. Results The daignosis of all 77 cases were only based on pre-operative physical and ultrasound examination. The post- reoperative follow up （ 3 -41 monthes） ：no case was found local recurrence. Conclusions The preoperative frozen section may avoid misdaignosis and the effect of reoperation for misdaignosed cases are satisfactory.
出处
《中华内分泌外科杂志》
CAS
2009年第4期239-242,共4页
Chinese Journal of Endocrine Surgery
关键词
甲状腺癌
误诊
再手术
Thyroid carcinoma
Misdiagnosis
Reoperation
