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1、維普資訊http://www.cqvip.com一88一ChineseArchOtolaryngolHeadNeckSurg甲狀腺癌侵及氣管的外科處理韓多吉李霄鵬一李建東賈深汕韓北秋?摘要目的:探討侵及氣管的甲狀腺癌的外科處理方法及療效。方法:回顧性分析了1975年~1999年共收治的侵及氣管的甲狀腺癌71例,根據(jù)侵及程度分三類:僅侵及氣管外膜;侵及氣管軟骨;侵及氣管全層并突入管腔引起呼吸困難。術(shù)中分別行切除氣管外膜、氣管壁開窗造瘺、部分氣管切除及全喉切除術(shù)。其中17例未分化癌患者術(shù)后均行放療。甲狀腺濾泡癌及乳頭濾泡癌患者均行碘”治療。結(jié)果:分化
2、型甲狀腺癌,1年生存率94.4%,3年生存率88.9,5年生存率85.2%,10年生存率31.5。未分化型患者17例均在1年內(nèi)死亡。結(jié)論:侵及氣管的甲狀腺癌在全身狀態(tài)允許的條件下是可以采用外科手術(shù)治療的,但未分化型甲狀腺癌的預(yù)后較差。關(guān)鍵詞甲狀腺腫瘤(Thyroidneoplasms)癌(Carcinoma)氣管(Trachea)外科,手術(shù)(Surgery,operative)ThesurgicaltreatmentofthyroidcarcinomainvolvedtracheaReportof71casesHanDuoji,LiXiaopen
3、g,Lidiandong,JiaShenshan,HanBeiquiABSTRACTObjective:Toinvestigatethesurgicaltreatmentandprognosisofthyroidcarcinomainvolvedtrachea.Methods:Seventyonepatientswiththyroidcancerinvolvedtracheaweretreatedinourdepartmentfrom1975to1999.Among71cases,43involveddepthofthetracheawall(g
4、roupA),21involvedthecartilageofthetrachea(groupB)and7involvedthewholewalloftracheaandtumorintothelumen,causingthedyspnea(groupC).ThesurgicalapproachwasadoptedresectiontheadventitiaforgroupA,tracheostomyandpartiallyresectiontracheaforgroupB,tracheotomyandlaryngectomyforgroupC.
5、Thepostoperationradiationtherapywasgiven40tO70Gyfor17casesofnon—differentialthyroidcarcinoma.Resuhs:Inthe54casesofdifferentialthyroidcarcinoma,thesur—vivalrateof1一year,3-year,5-yearand10一yearwas94.4%(51/54),88.9%(48/54),85.2%(46/54)and31.5(17/54)respectively.Seventeenpatients
6、withnon—differentialthyroidcarcinomadiedwith—inoneyear.Conclusion:Thesurgicaltreatmentofpatientswiththyroidcarcinomainvolvedtracheahavebeneficialforimprovelivequalitywhenthepatientshaveabettercondition.Patientswithnon—differentialthyroidcarcinomahavepoorprognosis.[ChineseArch
7、OtolaryngolHeadNeckSurg,2003;10(2):88~9OFromtheDepartmentofHeadandNeckSurgey,ThirdAffiliatedHospitalofHarbinMedicalUniver—sity,Harbin150040(Dr.HanDuoji)]我科自1975~1999年共收治甲狀腺癌1ll4例。例,60.6%),侵及氣管軟骨(21例,29.6),侵及氣管其中71例不同程度侵及氣管及鄰近組織。本文就71全層腫瘤突入管腔內(nèi)(7例,9.9)三大類。甲狀腺癌例氣管及鄰近器官受侵病例的外科處理進(jìn)
8、行總結(jié)。侵及氣管全層腫瘤突入管腔內(nèi)多為分化型甲狀腺癌,本文7例侵及氣管腔的病人均為分化型甲狀腺癌。未1材料與方法分化型甲狀腺癌,惡性程度