甲狀腺乳頭狀微小癌預(yù)后因素及手術(shù)范圍的回顧性分析.pdf

1、新疆醫(yī)科大學(xué)碩士學(xué)位論文甲狀腺乳頭狀微小癌預(yù)后因素及手術(shù)范圍的回顧性分析姓名：張海峰申請(qǐng)學(xué)位級(jí)別：碩士專(zhuān)業(yè)：外科學(xué)（普通外科學(xué)）指導(dǎo)教師：羅軍201104新疆醫(yī)科大學(xué)碩士學(xué)位論文新疆醫(yī)科大學(xué)碩士學(xué)位論文2RetrospectiveStudyofPrognosticFactSurgicalExtentfPapillaryThyroidmicrocarcinoma.Postgraduate:ZhangHaifengSupervis:Asso

2、ciateProf.LuoJunAbstractObjective:Tostudytheprognosticfactssurgicalextentofthyroidglnecklymphnodedissectionfpapillarythyroidmicrocarcinoma(PTMC).TomakereferencefprognosisthechoicesofsurgicalextenttoPTMC.Methods:Tosearcht

3、heChineseliteratureswiththeseriesdatabaseofCNKI(1979~2010).TosearchtheEnglishliteratureswiththeseriesdatabaseofOVIDPumedEBSCOEMBASESpringerLinkScienceDirect.Todeterminetherelationshipsbetweenprognosticfactsrecurrenceafte

4、rinitialoperationbymetaanalysis.DiscussthesurgicalextentfPTMC.Results:Romizedcontrolledtrialscasecontrolstudieshavenotbeengot.Atotalof12retrospectivestudieswereincluded.Resultsofmetaanalysisshowthatfactssuchasmalestumsiz

5、e＞5mmnonincidentalpositivelymphnodemultifocalcapsularinvasionarerelatedwiththerecurrenceafterinitialsurgery.Ageabove45yearshasnothingtodowiththerecurrencerateofPTMC.There’snosignificantdifferenceinrateofrecurrencebetween

6、prophylacticneckdissectiongroupsthegroupswithoutprophylacticneckdissection.Conclusion:TherecurrenceafterinitialsurgeryofPTMCarerelatedwithmalestumsizenonincidentalpositivelymphnodemultifocalcapsularinvasionbutnotwithage.

7、Thepatientswithonemeriskfactsshouldbeheldtotalsubtotalthyroidectomytheunilaterallobectomyshouldbegiventothepatientswithoutanyriskfacts.ProphylacticneckdissectionshouldnotbeusedasconventionalsurgicalfPTMC.Bilateralcentral

8、lymphnodedissectionisappropriatetoPTMCwithpositivelymphnode.PatientswithPTMCshouldbegivenintegratedestimationtotheirprognosisfappropriatepostoperativetreatment.Keywds:ThyroidcancerPapillarySurvivalAnalysisSurgicalProcedu