Chinese Journal of Practical Surgery ›› 2023, Vol. 43 ›› Issue (08): 925-928.DOI: 10.19538/j.cjps.issn1005-2208.2023.08.19

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  • Online:2023-08-01 Published:2023-08-24

心脏移植受者行甲状腺癌根治术的围手术期管理(附1例报告)

万    政a,苗    欣a,刘    靖b,吴    扬c,张淋淋a,何    丽b,李    杰d,张明博e,康红军f,刘    浩g,曹宝林h,刘    林a,姚    京a,菅雁兵a,王    冰a,阳泽龙a,刘子靖a,李    晨a,田    文a   

  1. 中国人民解放军总医院第一医学中心   a.普通外科医学部甲状腺(疝)外科   b.麻醉手术中心   c.心血管外科  d.病理科   e.超声科   f.重症医学科   g.临床药学室   h.核医学科,北京 100853   

Abstract: Perioperative management of heart transplant recipients undergoing radical thyroidectomy:a report of 1 case            WAN Zheng*, MIAO Xin , LIU Jing, et aL.*Department of Thyroid & Hernia Surgery, Medical Department of General Surgery,the First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
Corresponding authors:TIAN Wen,E-mail:tianwen301_cta01@163.com;LI Chen, E-mail:lichen_pla301@163.com
WAN Zheng and MIAO Xin are the first authors who contributed equally to the article
Astract    Objective    To discuss the perioperative management of thyroid cancer (TC)  after heart transplantation.Methods    A single TC case diagnosed 1 year after heart transplantation in February 2023 in the First Medical Center, Chinese People's Liberation Army General Hospital was retrospectively analyzed. Results    After completing the multidisciplinary team(MDT), the patient was treated with radical resection of thyroid cancer (total thyroidectomy + central lymph node dissection). After the surgery, vital signs showed stable, cardiopulmonary function was normal,and there was no symptoms of hoarseness, difficulty drinking, or hand/mouth numbness. MDT followed up with 131I therapy and thyroid stimulating hormone(TSH) suppression therapy before discharge.Conclusion    Heart transplant recipients undergoing TC surgery are at high risk. To ensure the perioperative safety, MDT is important to be applied throughout the process. The treatment plan should be individualizing formulated according to the medical treatment level of own center and the physical condition of the patient. 

Key words: solid organ transplantation, thyroid cancer, perioperative management, heart transplantation

摘要: 目的    探讨心脏移植术后甲状腺癌的围手术期管理。方法    回顾分析中国人民解放军总医院第一医学中心2023年2月收治的1例心脏移植术1年后发生甲状腺癌病例诊治经验。结果    经多学科综合治疗协作组(MDT)讨论后行甲状腺癌根治术(甲状腺全切除术+中央区淋巴结清扫)。术后病人生命体征稳定,心肺功能正常,未见明显并发症出现。出院前再次经MDT讨论后决定行促甲状腺激素(TSH)抑制治疗及131I治疗。结论    心脏移植术受者行甲状腺癌手术风险较高,围手术期管理应结合实际医疗水平并充分评估病人个人身体状况,将MDT诊疗模式贯穿治疗过程始终,制定适合病人的个体化治疗方案。

关键词: 实体器官移植, 甲状腺癌, 围手术期管理, 心脏移植