甲状腺结节87例临床诊断与治疗分析

Clinical Diagnosis and Treatment of 87 Cases of Thyroid Nodule

目的研究甲状腺结节的临床诊断方法及根据患者具体的临床表现,探讨有效、最佳的治疗方案和措施。方法随机选取包头医学院第一附属医院普外二科2013年2月—2015年4月收治的87例甲状腺结节患者,根据甲状腺结节的个数及特点进行分组,对其临床病案资料进行解读和分析,了解每例患者入院前诊断情况,通过血清学检查、超声检查、细针穿刺细胞学检查、颈部X线检查、甲状腺功能测定等方法确诊。计算诊断准确率,并随访调查3个月,评估最终的治疗效果。结果 87例患者,实质性单结节26例、多结节甲状腺肿21例、囊肿良性或恶性退行性结节5例、摸不到的结节11例、放射结节22例,选用的治疗方案有差异。一次确诊67例、二次确诊17例、诊断准确率96.55%,随访调查结果 ,治愈60例、好转24例、无效3例,无复发案例。结论临床诊断甲状腺结节的诊断效率很高,既往病史、体格检查、超声检查、细针穿刺细胞等检查项目,都能够高效确诊甲状腺结节,常用治疗方案有药物治疗、手术切除,诊断及时、治疗有效,治疗有效率和复发率越低。

Objective This paper tries to study the method of clinical diagnosis of thyroid nodules and to discuss the best treatment plan and effective measures according to the specific clinical manifestation of patients.Methods 87 cases of patients with thyroid nodules were randomly selected in the hospital from February 2013 to April 2015,and grouped according to the number and characteristics of thyroid nodules,and the clinical medical record was interpreted and analyzed,the diagnosis results of each patient prior to admission were understood and confirmed by serological examination,ultrasonography,fine needle aspiration cytology,neck X-ray examination,thyroid function test and other methods.The diagnostic accuracy was calculated in the follow-up survey for three months,and the therapeutic effect was evaluated.Results Among the 87 patients,26 cases of substantive single nodule,21 cases of nodular goiter,5 cases of benign or malignant cyst degenerative nodules,intangible nodules in 11 cases,22 cases of radiation nodules,with different treatment options.First confirmed of 67 cases,secondary diagnosis of 17 cases,diagnostic accuracy rate of 96.55%,according to the follow-up survey,60 cases cured,24 cases improved,and 3 cases not improved,no case of recurrence.Conclusion The clinical diagnosis efficiency of thyroid nodule is very high,medical history,physical examination,ultrasound,fine needle puncture cells checking are effective in the diagnosis of thyroid nodules,commonly used treatment with drug therapy,surgical resection,effective diagnosis and timely treatment,with higher effectiveness and lower recurrence rate.