结节性甲状腺肿合并甲状腺微小癌的诊断与治疗

An analysis on 42 cases with nodulargoiter combined with thyroid microcarcinoma

目的:总结结节性甲状腺肿合并甲状腺微小癌的诊治经验。方法:回顾性分析2001年1月至2007年3月收治的42例结节性甲状腺肿合并甲状腺微小癌的临床资料。结果:同期手术治疗结节性甲状腺肿患者836例,合并甲状腺微小癌42例(42/836,5.02%),其中术前诊断3例。所有患者均行术中快速冷冻病理检查,并根据病理检查结果采取不同的手术方式。术中冰冻病理结果微小癌39例(92.9%),其中乳头状癌37例,滤泡状癌2例;术后石蜡病理切片证实42例,其中乳头状癌40例,滤泡状癌2例。结论:结节性甲状腺肿临床中常见,但并发甲状腺微小癌时术前诊断困难,术中快速冷冻病理检查有利于选择正确的手术方式,使治疗更加合理有效。

Objective： To explore the clinical experience to treat nodulargoiter combied with thyroid microcarcinoma. Methods ： From 2001 to 2007, 42 patients with nodulargoiter combied with thyroid microcarcinoma were trea- ted in our hospital,their clinical data was analysed retrospectively. Results： In 836 patients with nodulargoiter, thyroid carcinoma was 42 （5.02%） ,3 cases were found before operation. All patients had accepted rapid frozensection intraoperation ,and selected appropriate operative methods according to pathological results. Conclusion： Nodulargoiter is a common disease ,but discovering thyroid microcarcinoma in preoperation is difficult. The rapid frozen section intraoperation can help us to select correct operative methodst.