目的:总结和探讨甲状旁腺癌的诊断和治疗方法。方法:回顾性总结本院5例甲状旁腺癌的临床资料。结果:5例患者术前颈部均扪及质硬包块,平均血钙浓度为3.82 mmol/L,平均PTH浓度为153.6 pmol/L,4例术中发现周围浸润表现。5例中4例同时行甲状旁腺肿瘤和同侧甲状腺腺叶切除,1例仅行甲状旁腺肿瘤切除。5例术后均诊断为甲状旁腺癌。术后4例得到随访,时间4月～5年。其中2例术后无复发;1例于术后半年局部复发行患侧甲状腺切除,后无复发;1例因全身转移于术后8个月死亡。结论:甲状旁腺癌的诊断非常困难,异常高浓度血钙、血PTH及术中浸润表现和组织病理学特征是甲状旁腺癌诊断的重要依据,99m-Tc-MIBI扫描及超声是病变定位的首选手段,肿瘤及其周围受侵组织的“整块切除”(en bloc resection)是首选的治疗方式。
ObjectiveTo observe the effectiveness and safety of pseudomonas aeruginosa preparation in treating refractory seroma after breast cancer surgery.MethodsA total of 76 patients with refractory seroma after breast cancer surgery who underwent surgery from October 2018 to August 2019 in our hospital were selected. The subjects were randomly divided into two groups. The patients in the control group (n=36) adopted negative pressure drainage connected with indwelling needle in the lower position of the seroma chamber; on the basis, patients in the experimental group (n=400) were injected with pseudomonas aeruginosa preparation into the seroma chamber. The drainage time, total drainage volume, recurrence rate, and incidence of complications of the two groups were compared.ResultsThere were 4 cases in the experimental group and 3 cases in the control group were lost followed-up, so only 69 cases enrolled in data analysis. The drainage time, total drainage volume, and the recurrence rate of the experimental group were all shorter or less than those of the control group (P<0.05). But there was no significant difference in the incidence of complications between the experimental group and the control group (P>0.05), such as fever, inflamed skin, and infection of incision.ConclusionPseudomonas aeruginosa preparation is an effective treatment for refractory seroma after breast cancer surgery, which can shorten the drainage time and promote wound healing.