甲状腺癌术后平常的并发症有哪些?
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲状腺乳头状癌是甲状腺癌里最<span style="color: black;">平常</span>的一个类型。手术以后,<span style="color: black;">非常多</span><span style="color: black;">病人</span>都<span style="color: black;">必须</span><span style="color: black;">吃下</span>甲状腺素片(最常用的是「<span style="color: black;"><a style="color: black;">优甲乐</a></span>」)治疗,并且还要<span style="color: black;">按照</span>医嘱<span style="color: black;">定时</span>复查。<span style="color: black;">重点</span>目的<span style="color: black;">便是</span>防止、或及早<span style="color: black;">发掘</span>癌症的复发、转移。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲状腺癌术后容易复发吗?<span style="color: black;">那些</span>类型的<span style="color: black;">病人</span>复发的可能性比<span style="color: black;">很强</span>?甲状腺癌术后复发了,还能再次手术吗?快来<span style="color: black;">瞧瞧</span><span style="color: black;">大夫</span>怎么说。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">01甲癌术后会复发吗?</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">答:只要是癌,理论上来讲都存在复发的<span style="color: black;">危害</span>,甲状腺癌<span style="color: black;">亦</span>不例外,<span style="color: black;">然则</span><span style="color: black;">因为</span>甲状腺癌的生物学<span style="color: black;">行径</span>比较好,治疗的效果比较好,对手术<span style="color: black;">药品</span>的反应比较好,<span style="color: black;">因此</span>甲状腺癌复发率是很低的,<span style="color: black;">然则</span><span style="color: black;">亦</span>存在<span style="color: black;">必定</span>的复发的<span style="color: black;">危害</span>。甲状腺癌复发,<span style="color: black;">按照</span>病理类型不同而有差异。<span style="color: black;"><a style="color: black;">分化型甲状腺癌</a></span>,其生物学<span style="color: black;">行径</span>偏良性,临床数据显示十年<span style="color: black;">存活</span>率能够达到70-90%以上。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">治疗后按病症<span style="color: black;">状况</span><span style="color: black;">定时</span>复查,<span style="color: black;">通常</span>病期2-3年,3-4个月复查一次,病期2-5年,每半年复查一次,五年以后每年都得复查一次,复查内容<span style="color: black;">重点</span>为<span style="color: black;">大夫</span>触诊及CT、磁共振等影像学<span style="color: black;">检测</span>,经规范治疗和<span style="color: black;">定时</span>复查,<span style="color: black;">存活</span>期是非常<span style="color: black;">阳光</span>的。即使复发,<span style="color: black;">经过</span><span style="color: black;">即时</span>积极地治疗,<span style="color: black;">存活</span>期<span style="color: black;">亦</span>是比较长的。而<span style="color: black;"><a style="color: black;">未分化</a></span>型的甲状腺癌,恶性程度较高,术后<span style="color: black;">存活</span>率非常低,两年<span style="color: black;">存活</span>率<span style="color: black;">亦</span>不足10%。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">02甲癌术后复发,还能再次手术吗?</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">甲状腺癌的复发,<span style="color: black;">常常</span><span style="color: black;">出现</span>在原发肿瘤处、或<span style="color: black;"><a style="color: black;">颈部淋巴结</a></span>,<span style="color: black;">因此呢</span>,首选的治疗<span style="color: black;">办法</span>是再次手术 。乳头状癌和<span style="color: black;"><a style="color: black;">髓样癌</a></span>容易<span style="color: black;">出现</span>淋巴结转移,再次手术时,<span style="color: black;">大夫</span>会做患侧颈部淋巴结清扫术。<span style="color: black;">倘若</span><span style="color: black;">无</span><span style="color: black;">显现</span><span style="color: black;"><a style="color: black;">颈部淋巴结转</a>移</span>,再次手术<span style="color: black;">必须</span>清扫吗?医学界尚未达成一致。但<span style="color: black;">意见</span>这些<span style="color: black;">病人</span>做<span style="color: black;"><a style="color: black;">Ⅵ区淋巴结</a></span>清扫。<span style="color: black;">重点</span><span style="color: black;">思虑</span>到:1、淋巴结转移率高,受解剖部位影响,常规<span style="color: black;">检测</span><span style="color: black;">很难</span><span style="color: black;">发掘</span>;2、Ⅵ区<span style="color: black;">倘若</span>再手术,很容易<span style="color: black;">损害</span><span style="color: black;"><a style="color: black;">喉返神经</a></span>等<span style="color: black;">要紧</span>结构;3、摸清Ⅵ区淋巴结<span style="color: black;">状况</span>,有助于<span style="color: black;">大夫</span><span style="color: black;">思虑</span>进一步治疗<span style="color: black;">方法</span>。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">03再次手术什么时候做?</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>身体<span style="color: black;">前提</span><span style="color: black;">准许</span>,最好在<span style="color: black;">发掘</span>复发后尽早(1周内)手术、或手术区水肿消退3个月后手术。<span style="color: black;">另外</span>,首次手术切除范围对再次手术的时间<span style="color: black;">亦</span>有影响,<span style="color: black;">倘若</span>首次手术未<span style="color: black;">触及</span>喉返神经和<span style="color: black;"><a style="color: black;">甲状旁腺</a></span>区域,再次手术就<span style="color: black;">能够</span>提前。<span style="color: black;">倘若</span>首次手术<span style="color: black;">损害</span>了喉返神经,<span style="color: black;">大夫</span>会观察神经恢复<span style="color: black;">状况</span>,适当推迟再次手术的时间。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">04再次手术有什么<span style="color: black;">危害</span>?</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">倘若</span>首次手术只切除了一部分甲状腺,复发后再次手术切除另<span style="color: black;">一边</span>甲状腺,<span style="color: black;">危害</span>比较低,<span style="color: black;">由于</span>两次手术的<span style="color: black;">目的</span>区域不同。但<span style="color: black;">倘若</span>在前次手术区域再次手术,以前手术形成的瘢痕和黏连使手术区解剖结构改变,<span style="color: black;">大夫</span>难以找到喉返神经和甲状旁腺等<span style="color: black;">要紧</span>结构,<span style="color: black;">损害</span><span style="color: black;">危害</span>加大,术中和术后并发症<span style="color: black;">危害</span><span style="color: black;">升高</span>。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">总结 <span style="color: black;">针对</span>大部分乳头状癌或<span style="color: black;"><a style="color: black;">滤泡癌</a></span>而言,其复发率较低。但<span style="color: black;">亦</span>有部分<span style="color: black;">病人</span>存在复发,可<span style="color: black;">经过</span>超声、血液<span style="color: black;">检测</span><span style="color: black;">发掘</span>新生<span style="color: black;"><a style="color: black;">结节</a></span>、淋巴结转移。<span style="color: black;">倘若</span>术后<span style="color: black;">发掘</span>新生结节生长<span style="color: black;">快速</span>,<span style="color: black;">思虑</span>低分化或<span style="color: black;"><a style="color: black;">未分化癌</a></span>。复发后,<span style="color: black;">倘若</span>单纯为甲状腺乳头状癌,<span style="color: black;">思虑</span>再次手术进行切除,<span style="color: black;">针对</span>低分化或未分化癌,可<span style="color: black;">思虑</span>综合治疗。</p>
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