未分化甲状腺癌中气道受损的处理及气管切开术的作用
Management of the compromised airway and role of tracheotomy in anaplastic thyroid carcinoma.
作者信息
Mani Navin, McNamara Katherine, Lowe Natalie, Loughran Sean, Yap Beng K
机构信息
Department of Otolaryngology - Head and Neck Surgery, The Christie Hospital, Manchester, United Kingdom.
Department of Otolaryngology, University Hospital of South Manchester, Manchester, United Kingdom.
出版信息
Head Neck. 2016 Jan;38(1):85-8. doi: 10.1002/hed.23857. Epub 2015 Jan 27.
BACKGROUND
Anaplastic thyroid carcinoma (ATC) is an uncommon thyroid malignancy with a poor prognosis. American Thyroid Association (ATA) guidelines acknowledge the complexity of airway management in these patients. We studied our local experience with the aim of providing guidance in airway management in ATC.
METHODS
Patients with histologically confirmed ATC from January 2004 to December 2011 were identified from our institutional database. The data were retrospectively analyzed using hospital case notes.
RESULTS
Twenty-six patients were identified with ATC, 25 of who died from the disease. Five of 26 patients (19%) had stridor at presentation. A further 6 of 26 patients (23%) developed stridor during or soon after radiotherapy. Nine patients (36%) died of airway obstruction.
CONCLUSION
Tracheotomy can facilitate completion of palliative treatment in those patients with ATC and stridor. Given the short life expectancy of these patients, a balanced decision must be made regarding the role and timing of tracheotomy.
背景
间变性甲状腺癌（ATC）是一种罕见的甲状腺恶性肿瘤，预后较差。美国甲状腺协会（ATA）指南认识到这些患者气道管理的复杂性。我们研究了我们当地的经验，旨在为ATC的气道管理提供指导。
方法
从我们机构的数据库中识别出2004年1月至2011年12月组织学确诊为ATC的患者。使用医院病历对数据进行回顾性分析。
结果
确定了26例ATC患者，其中25例死于该疾病。26例患者中有5例（19%）在就诊时出现喘鸣。另外26例患者中有6例（23%）在放疗期间或放疗后不久出现喘鸣。9例患者（36%）死于气道阻塞。
结论
气管切开术可促进ATC伴喘鸣患者姑息治疗的完成。鉴于这些患者预期寿命较短，必须就是否进行气管切开术及其时机做出权衡决策。
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