儿童甲状腺乳头状癌的外科治疗

摘要

Objective　 To study the clinical characteristics, surgical treatment and prognosis of thyroid papillary carcinoma in children.　 Method　 From 1980 to 1999, 19 children with thyroid papillary carcinoma underwent operative treatment in our hospital and all were followed up.　 Results　 The follow-up period was 1 to 18 years (mean＝7yrs). One died of pulmonary insufficiency from extensive pulmonary and cervical lymph nodes metastases two years after the operation, other patients were all alive and well, including a patient who had surgery three times in the past ten years for the recurrence of the tumor. 　Conclusions　 The prognosis of papillary carcinoma in children is usually excellent. Operation is the mainstay of the therapy. A proper surgical procedure is important for a better outcome. The second operation can also achieve a long survival for those who have recurrent papillary thyroid carcinoma or cervical lymph node metastases.%目的　 探讨儿童甲状腺乳头状癌的临床特点、外科治疗和预后。　方法　 回顾性分析我院 1980～1999年收治的19例儿童甲状腺乳头状癌，并进行随访。　结果　 本组均行手术治疗。术后随访时间1～18年，中位随访时间7年。除1例术中颈静脉角处有癌灶残留，术后2年出现颈部淋巴结及肺部广泛转移死亡外，其余患儿均生存良好（包括1例10年间3次手术的患儿）。　结论　 手术是治疗儿童甲状腺乳头状癌的主要方法。选择适宜的手术方式，避免并发症的发生，直接影响到患儿的预后。即使对有局部复发或颈部淋巴结转移的病例，再次手术仍可获得良好的效果。