儿童甲状腺结节的评估和管理

Evaluation and management of thyroid nodules in children

儿童甲状腺结节相比于成人在病理生理、临床表现及远期预后方面均有差异。儿童患者死亡风险小，而过于积极的治疗可能对其危害更大，成人的治疗方案对于儿童并不适用。儿童甲状腺结节的良、恶性评估主要依靠危险因素、甲状腺相关激素、超声检查及细针穿刺细胞学检查等。儿童良性结节以随访观察为主，而恶性结节需手术治疗，且术后需密切随访，并实施后续治疗。

Thyroid nodules in children exhibit differences in pathophysiology, clinical manifestation, and long - term outcomes compared with those in adults. Besides, the treatment which may be recommended for adults may not be suitable for children who are at low risk for death but at higher risk for long - term harm from exceedingly aggressive therapy. The evaluation of thyroid nodules includes risk factors, thyroid - related hormone, thyroid ultrasound and fine - needle aspiration biopsy, and so on. Benign lesions should be observed mainly by follow - up, however, for malignant lesions, total thyroidectomy or near is recommended, surveillance and follow - up should be maintained after thyroidectomy.