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内脏反位伴甲状腺髓样癌1例报道

卵巢甲状腺肿腹腔种植1例报道

目的总结1例卵巢甲状腺肿腹腔种植病例的诊治过程。方法回顾性分析2023年7月笔者所在医院收治的1例卵巢甲状腺肿腹腔种植患者的临床资料和病理结果。结果患者系55岁女性，因“腹痛4+ 年，盆腔包块切除术后4年” 入院。完善CT检查提示心膈角区、肝肾间隙包膜、腹膜、腹盆腔多发结节，既往于外院行子宫、右侧附件及部分腹腔结节切除术，术后病理提示为结节性甲状腺肿样的良性组织学表现。经笔者所在医院疑难病例讨论后，患者接受了甲状腺全切除手术，术中出血约为5ｍL，术后恢复良好、未见明显并发症。术后33 ｄ于核医学科接受131I放射治疗。出院后1个月于当地医院复查甲状腺功能正常，目前已随访5个月，甲状腺功能控制正常，颈部及腹部无不适，继续随访。结论卵巢甲状腺肿腹腔种植病例罕见，临床表现无特异性，诊断主要依据病理学证据，生物学行为具有惰性，临床干预首选完整切除卵巢肿物及腹膜结节，若不能完整切除或者随诊结节复发，可以行甲状腺全切除后131I放射治疗，但该治疗方案仍需更多研究进一步探讨。

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.