不同手术治疗方案对甲状腺结节患者治疗合理性及临床效果的探讨

Discussion on the rationality and clinical effect of different surgical treatments for patients with thyroid nodules

目的探讨不同甲状腺结节手术治疗方案的合理性及临床效果。方法选取本院2018年1月—2019年1月收治的120例患有甲状腺结节患者为研究对象,将其随机分为A组和B组各60例,A组患者未进行甲状腺细针抽吸细胞学检查直接进行甲状腺结节切除手术,B组患者接受超声负压引导甲状腺细针抽吸细胞学检查后给予手术治疗方案,比较两组患者手术前、后良恶性结节患者变化、术后复发率、并发症发生率及手术疗效。结果术后A组残余恶性结节患者比例高于B组(P=0.001),A组健康无结节病变患者占比低于B组(P=0.002),A组患者恶性结节复发率高于B组患者(P<0.05);两组术后并发症发生率无差异(P>0.05),A组手术治疗总有效率低于B组(P<0.05)。结论甲状腺结节患者术前有效超声穿刺诊断、术中超声引导手术及术后抗癌化疗治疗方案可以提高甲状腺结节患者手术有效率,B组方案具有重要临床推广价值。

Objective To investigate the rationality and clinical effect of different thyroid nodules surgical treatment.Methods A total of 120 patients with thyroid nodules admitted to our hospital from January 2018 to January 2019 were randomly divided into group A and group B,respectively.Group A patients did not undergo fine needle extraction.Aspiration cytology was performed directly for thyroid nodule resection.Group B patients underwent ultrasound negative pressure guided thyroid fine needle aspiration cytology and were given surgical treatment.The changes of benign and malignant nodules before and after surgery were compared between the two groups including postoperative recurrence rate,complication rate and surgical outcome.Results The proportion of patients with residual malignant nodules in group A was higher than that in group B(P=0.001).The proportion of patients with healthy no-nodular lesions in group A was lower than that in group B(P=0.002).The recurred rate of malignant nodules in group A was higher than that of group B(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).The total effective rate of group A was lower than that of group B(P<0.05).Conclusion Preoperative effective ultrasound puncture diagnosis,intraoperative ultrasound guided surgery and postoperative anticancer chemotherapy treatment may improve the efficiency of thyroid nodules in patients with thyroid nodules.Group B has important clinical value.