甲状腺微小乳头状癌89例外科诊疗分析

Diagnosis and Treatment Analysis of 89 Patients with Papillary Throid Microcarcinoma

目的:探索甲状腺微小乳头状癌(PTMC)诊疗的方法。方法:对2010年1月-2012年10月齐鲁石化中心医院普外科诊治的89例甲状腺微小乳头状癌各项临床资料进行回顾性分析。结果:高频彩超检查:结节内有微小沙粒样钙化者62例(79.4%),结节内或周围有较丰富血流者62例(32.4%),边界欠清有尾足者56例(61.8%),形态呈"站立式"生长、回声不均匀者48例(85.3%)。所有患者均顺利完成手术,其中患侧腺叶切除+峡部切除28例,患侧腺叶切除+峡部切除+对侧大部切除45例,甲状腺全切除16例,均行中央区淋巴结清扫。结论:高频彩超明显增加PTMC的早期检出率,PTMC不必全部行甲状腺全切术,行预防性中央区淋巴清扫是必要的。

Objective： To explore the early diagnosis and treatment methods of papillary thyroid mierocarcinoma （ PTMC ） .Method： Clinical data of 89 patients with PTMC who were admitted into general surgery department of qilu petrochemical center hospital from June 2011 to October 2012 were analyzed statistically.Result ：Through the supersonic inspection：there were 62 cases of tiny grains of sand sample calcified lesions in the nodules （ occupying 79.4% of the total cases ）, 62 cases of rich blood flow in the nodules or around （ occupying 32.4% ）, 56 cases of obscure boundary with tail foot （ occupying 61.8% ） and 48 cases of a ＂stand-up＂ growth form and uneven echo （ occupying 85.3% ） .28 cases had thyroid lobectomy and resection of isthmus operation, 45 cases had thyroid lobe resection, isthmus total resection and heterolateral subtotal operation, and 16 cases had bilateral total thyroidectomy operation, with central lymph nodes dissection performed.Conclusion： Through high-frequency uhrasonography increases the early detection rate of PTMC.PTMC needn＇t have thyroid bilaterall total thyroidectomy operation, while preventive central lymph nodes dissection is necessary.