Objective: To investigate the diagnosis, treatment and prevention of surgical complications in thyroid carcinoma. Methods: Clinical data of 282 thyroid carcinomas from January 2000 to December 2009 were analyzed retrospectively. Results :Total of 162 ( 57.4％ ) and 94 ( 33.3％ ) of the patients were diagnosed before and during operation, respectively, and 26 patients were diagnosed after operation. No hospital deaths occurred in the 282 cases after operation. A total of 9 cases showed temporary vocal cord paralysis, 2 cases showed permanent vocal cord paralysis, and 7 cases had convulsion or limbs numbness due to hypocalcemia. Follow - up of 249 cases showed cervical lymph node recurrence in 20 patients, local recurrence in 15 patients and distant metastasis in 10 patients. The 5 -year survival rates in differentiated and medullary thyroid carcinoma were 99.2％ and 92.3 ％, respectively. Conclusions: The thyroid nodule with calcification should be considered as thyroid carcinoma and intra - operative frozen section is helpful for the diagnosis and the choice of operation method. Patients should take thyroxine tablets for prophylaxis of tumor recurrence and metastasis.%目的:讨论甲状腺癌的诊断、治疗、术后并发症及复发转移的相关因素.方法:对2000年1月-2005年12月经手术治疗的282例甲状腺癌临床资料进行回顾性分析.结果:术前和术中诊断甲状腺癌分别为162例(57.4%)和94例(33.3%),术后确诊26例(9.3%);282例手术患者无院内死亡,11例出现了声嘶(9例为暂时性,2例为永久性),7例出现低钙抽搐或肢端麻木.249例(88.3%)获得随访资料,其中颈部淋巴结复发者20例,局部复发者15例,远处转移者10例.分化型甲状腺癌和髓样癌术后5年生存率分别为99.2%和92.3%.结论:甲状腺结节钙化者高度怀疑甲状腺癌,术中冷冻有助于甲状腺癌的确诊和术式的选择,应充分重视术中显露喉返神经,术后患者应坚持服用甲状腺素片,有助于预防甲状腺癌的复发转移.
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