264例甲状腺结节诊疗体会

目的分析甲状腺结节的发病情况,探讨归纳甲状腺结节的检查方法、诊疗原则、手术方式及并发症的预防。方法回顾总结我院2005年1月至2009年3月门诊及住院诊治甲状腺结节患者264例资料,结合文献进行分析讨论。结果经B超检查264例,符合者211例,符合率约79.9%;细针穿刺抽吸细胞学诊断123例,符合93例,符合率约75.6%。全组没有死亡病例,喉返神经损伤只有1例,在手术后4个月逐渐恢复;喉上神经损伤只1例,表现为饮水呛咳,在手术后第6天症状完全消失;甲状腺功能低下6例,手术后长期服用甲状腺制剂替代治疗,监测TSH水平在正常范围之内。作者随访2～5个月,其中6例结节性甲状腺肿复发再次手术。结论甲状腺结节手术治疗安全有效。准确鉴别甲状腺结节的性质,加强对甲状腺结节术前评估和手术方式选择,手术并发症的预防等方面的认识,很有必要。手术操作细致及手术细节上的改进可以预防并发症的发生。

Objective To analyse the onset of thyroid nodule,discuss the induction of thyroid nodule diagnosis inspection method,the principle,operation methods and the prevention of complications.Methods A retrospective review of summerize from jan 2005 to March 2009 outpatient service,and length of treatment of thyroid nodule patients 264 cases information,combined with literature are discussed.Results By b-ultrasonography,accord with the check 264 cases 211 cases about 79.9%,accuracy;fine needle aspiration biopsy suction cytology diagnosis with 123,accord with 93 cases,about 75.6% accuracy.No deaths,the group of recurrent laryngeal nerve damage in 1 case,only four months after the surgery gradually returned;laryngeal nerve damage only on 1 case,performance for drinking water after surgery to cough,choking the first six days in complete resolution of symptoms;low thyroid function in 6 cases,surgery long-term use of thyroid preparations replacement therapy,monitoring TSH level in a normal range.The author follow-up 2-5months,including six cases of recurrent nodular strumous repeat procedures.Conclusion Thyroid nodule surgical treatment is safe and effective.Accurately identify the nature of thyroid nodule,strengthen the thyroid nodule preoperative assessment and operation method choice,surgical complications aspects of prevention of understanding,it is very necessary.And the surgical operation meticulous on the details of improvement can prevent the occurrence of complications.