摘要
目的 探讨提高甲状腺癌 (甲癌 )诊断治疗水平的方法。方法 根据笔者的临床经验 ,结合复习近期国内外文献 ,提出在甲癌诊断治疗中应注意的有关问题。结果和结论甲癌在诊断中应注意囊性腺癌、多灶癌、双侧癌 ,甲状腺良性疾病与甲癌并存 ,以及甲状腺微小癌或隐匿癌等情况 ;对需手术治疗的甲状腺肿块 ,术中、术后均应行病理检查 ,以防甲癌漏诊 ;除未分化癌外 ,甲癌均以手术治疗为主。术式选择应根据病理类型、临床分期、病人情况等决定 ;术后应行甲状腺素激素抑制疗法 ;术后行外照射治疗可提高术后长期生存率 ;对仅行甲状腺叶次全切除或肿块切除的甲状腺结节 ,术后病理报告为甲癌的 ,应立即行再次手术 。
Objective To study the approach to improving the diagnosis and treatment of thyroid cancer(TC). Methods Problems regarding to the diagnosis and treatment of TC had arisen based on the combination of auther's clinical experience and recent literatures review. Results and Conclusions (1) In the diagnosis of TC, attention should be paid to the following conditions: cystocarcinoma, multicentral cancer, bilateral TC, coexist of benign thyroid diseases with TC, and the microcancer of thyroid etc. (2) Biopsy should be done during and after operation for the thyroid nodule needed to be operated, to avoid misdiagnosis of TC. (3) Except undifferentiated carcinoma, the choice of treatment of TC is surgery. The choice of operative procedure should be according to the pathological type and clinical stage of TC, and patient's condition. (4) Thyroid hormone suppression therapy should be administrated after operation. (5) Posterative radiotherapy can promote the long term survival rate. (6) Reoperation should be performed immediately, if the thyroid nodule is TC and comfired by pathological examination posteratively, and a subtotal thyroidectomy or nodule local resection performed on for that nodule initially, to avoid the residual cancer and cancer recurrence in the residual thyroid tissues.
出处
《中国普通外科杂志》
CAS
CSCD
2000年第6期481-483,共3页
China Journal of General Surgery
