摘要
目的探讨肾性甲状旁腺功能亢进合并甲状腺癌不同手术方式的选择。方法回顾性分析2012年2月~2019年8月就诊于解放军第九六〇医院甲状腺乳腺外科肾性甲状旁腺功能亢进合并甲状腺癌患者甲状旁腺全切加部分腺体自体移植+甲状腺全切±淋巴结清扫术前后的临床资料,包括术前诊断、手术方式、病理结果及实验室检查等。随访2~90个月,中位随访时间60(8,48)月,观察临床症状改善及有无复发等。结果 480例接受手术的继发性甲状旁腺功能亢进患者中16例合并甲状腺癌,发病率为3.3%。15例患者1次完成手术,1例患者接受2次手术,病理检查结果 16例均为甲状腺乳头状癌。16例患者均采用甲状腺全切术,12例接受中央区淋巴结清扫术,2例患者接受颈侧区淋巴结清扫术。共切除62枚甲状旁腺,手术后患者临床症状缓解,相关生化指标较术前下降或维持正常。随访期间无复发病例。结论肾性甲状旁腺功能亢进患者术前要充分评估甲状腺病变性质,精确合理的手术范围能获取最佳的外科治疗效果。
Objective To explore the choice of surgical methods for renal hyperparathyroidism complicated with thyroid carcinoma. Methods The clinical data including preoperative diagnosis, surgical methods, pathological results and laboratory examinations of the patients with renal hyperparathyroidism complicated with thyroid cancer treated in the Thyroid and Breast Surgery of the 960 th Hospital of the People’s Liberation Army from February 2012 to August 2019 were retrospectively analyzed. The patients were followed up for 2~90 months(median follow-up period 60 months). The improvement of clinical symptoms and recurrence were observed. Results In the 480 patients with renal hyperparathyroidism undergoing parathyroidectomy, 16(3.3%) were found to accompany with thyroid cancer. Surgery was successfully performed in 15 cases, and one case underwent re-operation. Pathologically, all of the 16 thyroid cancer samples were papillary thyroid carcinoma. Total thyroidectomy was performed in the 16 cases, 12 of them received central lymphadenectomy and 2 of them received lateral cervical lymph node dissection. A total of 62 parathyroid glands were resected. The clinical symptoms of the patients relieved after operation, and the related biochemical indexes improved or became normal compared with those before the operation. No recurrence occurred during followup. Conclusion Patients with renal hyperparathyroidism should carefully assess the character of the thyroid lesions before operation. The best surgical effect can be obtained by accurate and appropriate design of the operation area.
作者
周鹏
庄大勇
贺青卿
朱见
胡金枝
岳涛
李小磊
徐婧
ZHOU Peng;ZHUANG Da-yong;HE Qing-qing;ZHU Jian;HU Jin-zhi;YUE Tao;LI Xiao-lei;XU Jing(Department of Thyroid and Breast Surgery,the 960th Hospital of the People’s Liberation Army of China,Jinan 250031,China)
出处
《中国血液净化》
CSCD
2020年第7期454-457,共4页
Chinese Journal of Blood Purification
基金
解放军第九六〇医院院长基金资助项目(2018ZX01)。
