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內臟反位伴甲狀腺髓樣癌1例報道

卵巢甲狀腺腫腹腔種植1例報道

目的總結1例卵巢甲狀腺腫腹腔種植病例的診治過程。方法回顧性分析2023年7月筆者所在醫院收治的1例卵巢甲狀腺腫腹腔種植患者的臨床資料和病理結果。結果患者系55歲女性，因“腹痛4+ 年，盆腔包塊切除術后4年” 入院。完善CT檢查提示心膈角區、肝腎間隙包膜、腹膜、腹盆腔多發結節，既往于外院行子宮、右側附件及部分腹腔結節切除術，術后病理提示為結節性甲狀腺腫樣的良性組織學表現。經筆者所在醫院疑難病例討論后，患者接受了甲狀腺全切除手術，術中出血約為5ｍL，術后恢復良好、未見明顯并發癥。術后33 ｄ于核醫學科接受131I放射治療。出院后1個月于當地醫院復查甲狀腺功能正常，目前已隨訪5個月，甲狀腺功能控制正常，頸部及腹部無不適，繼續隨訪。結論卵巢甲狀腺腫腹腔種植病例罕見，臨床表現無特異性，診斷主要依據病理學證據，生物學行為具有惰性，臨床干預首選完整切除卵巢腫物及腹膜結節，若不能完整切除或者隨診結節復發，可以行甲狀腺全切除后131I放射治療，但該治療方案仍需更多研究進一步探討。

Analysis of different types of trainee physicians participating in surgery: taking thyroid and parathyroid surgery as an example

ObjectiveTo discuss the participation of different types of trainee physicians in surgery during rotation practice to provide reference for optimizing the training of clinical surgeons taking thyroid and parathyroid surgery as an example. MethodsThe cases of thyroid surgery in West China Hospital of Sichuan University from September 2021 to May 2022 were prospective randomly selected and the surgical participation of younger trainee physicians (interns, professional postgraduates, and training physicians) and older trainee physicians (refresher physicians, resident and attending physicians of our hospital) were analyzed. ResultsAmong the 787 surgical cases, compared with the older trainee physicians, the younger trainees had a lower surgical participation rate, shorter participation time and were more likely to participate in the first 1–3 surgeries and participate as the second or third assistant. ConclusionThe surgical training of younger trainee physicians, such as interns, professional postgraduates, and training physicians, still needs to be improved.