| 张方捷,叶 静.妊娠期分化型甲状腺癌26例诊治体会[J].肿瘤学杂志,2015,21(11):900-903. |
| 妊娠期分化型甲状腺癌26例诊治体会 |
| The Experience of the Diagnosis and Treatment of 26 Cases with Differentiated Thyroid Cancer During Pregnancy |
| 投稿时间：2015-07-27 |
| DOI：10.11735/j.issn.1671-170X.2015.11.B008 |
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| 中文关键词: 妊娠 甲状腺肿瘤 分化型癌 随访 外科手术 |
| 英文关键词:pregnancy thyroid neoplasms differentiated carcinoma follow-up surgery |
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| 摘要点击次数: 1929 |
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| 中文摘要: |
| 摘 要：［目的］ 探讨与总结妊娠期分化型甲状腺癌的诊治经验。［方法］ 妊娠期分化型甲状腺癌26例，通过超声与细针穿刺活检评估肿瘤的大小、生长速度、淋巴结转移和病理类型，选择合适的治疗方案。随访内容包括促甲状腺激素（TSH）、游离甲状腺素4（FT4）、颈部超声与分娩情况。［结果］ 26例患者诊断时间为妊娠早期9例，中期11例，晚期6例；评估肿瘤高危因素后，6例患者在妊娠期接受手术，20例在产后手术。所有患者均顺利分娩，平均随访时间（35.3±18.4）个月，25例患者未发现复发或转移征象，1例患者淋巴结转移再次颈淋巴结清扫，无死亡病例。［结论］ 妊娠期分化型甲状腺癌的治疗建议多学科讨论决定治疗方案。如不具备高危因素，建议将手术时间推迟至妊娠中晚期或产后。需要规范精准的手术操作，严格的术后随访来保证患者与胎儿的健康与生命。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the experience of the diagnosis and treatment of patients with differentiated thyroid cancer(DTC) during pregnancy.［Methods］ Ultrasound and fine needle aspiration biopsy(FNAB) were used in 26 women with DTC during pregnancy to evaluate the nodule size，growth rate，lymph node metastasis and the histological type，so as to make treatment decision. Thyroid stimulating hormone(TSH)，free thyroxine 4(FT4)，ultrasound for the neck and the delivery of patients were followed up.［Results］ There were 9 patients confirmed DTC during the first trimester of pregnancy，11 patients during the second and 6 patients during the third. After the risk factors were evaluated，6 patients accepted operations during pregnancy，20 patients did after delivery. All patients had successful delivery. After following up for（35.3±18.4）months，no recurrence or metastasis was found in 25 patients，and one patient had lymph node metastasis and underwent secondary dissection.［Conclusions］ Treatment for DTC during pregnancy needs cooperation of multidisciplinary teams. If there were no risk factors，surgery should be postponed to the time after the second trimester of pregnancy or the post-delivery period. Standard and accurate operation，strict follow-up are needed to guarantee the patients and newborns’ healths and lives. |
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