甲状腺单发结节的外科治疗986例报告

Surgical treatment of solitary thyroid nodule in 986 patients

１９８６年１月～１９９４年１２月的９年间收治９８６例甲状腺单发结节，全部手术治疗。术前诊断甲状腺肿９２７例、甲状腺癌或可疑腺癌１４例。术后病理明确诊断甲状腺瘤８２２例，桥本氏病１９例，甲状腺肿６５例，甲状腺癌８０例，恶性率达８％。手术方式第一次以单纯结节摘除３１３例，病理检出癌肿３２例，３２例中２周内再次根治手术１９例，其中１例甲状腺残体内还有癌灶，８例找到邻近淋巴结转移。相当一部分手术只是单纯结节摘除，大部分从此得到长期治愈，但单纯摘除至少有２５％的癌肿切除不彻底。结节性甲状腺肿易致“假性复发”，所以对单发结节在未确定性质之前，不可采用结节局部切除。

Abstract In this study, operation was performed on 986 patients with solilary nodular thyroid lesions between Jan.1986 and Dec. 1994. Preoperative diagnosis included thyroid adenoma or thyroid goiter in 972 cases tantative carcinoma in 14 patients. Postoperative final diagnosis was thyroid adenoma in 822 patients, Hashimoto disease in 19 patients simple goiter in 65 patients, and carcinoma in 80 patients, witha malignancy rate of 8%. Among 313 patients undergoing simple excision of the nedule maliganancy was found in 32 patients, and 19 of the 32 had ramdical operation done within 2 weeks. One was found to have carcinoma in the residual lesion rem oved.Eight patients were with lymphoid metastasis. The authors do not recommend simple nodular excision in patients with solitary thyroid nodule.