甲状腺结节病例特点分析及其临床诊治意义

Characteristics of thyroid nodule cases and its clinical significance for diagnosis and treatment

目的分析甲状腺结节术后患者的临床及病理资料,探讨恶性甲状腺结节的特点及临床诊治的意义。方法收集江苏省中医院2019年1月至2021年6月收治的177例甲状腺结节术后患者的临床资料,所有患者根据病情需要分别行甲状腺单侧切除、全切、根治性淋巴清扫手术,回顾性分析患者临床资料及术后病理、淋巴结转移情况。结果177例甲状腺结节患者中,男43例(24.3%),女134例(75.7%)。男性与女性甲状腺结节恶性率及淋巴结转移率差异无统计学意义(72.1%vs 76.9%,51.6%vs 52.4%,P>0.05)。20~40岁年龄段的男性及女性甲状腺结节恶性率差异无统计学意义,但男性淋巴结转移率高于女性(69.2%vs 35.9%,χ^(2)=4.392,P<0.05)。40岁以上年龄段,男、女性甲状腺结节恶性率及淋巴结转移率差异无统计学意义(P>0.05)。20~40岁、40岁以上两个年龄段的男性甲状腺结节恶性率差异无统计学意义,但20~40岁淋巴结转移率高(69.2%vs 33.3%,P<0.05);20~40岁年龄段女性甲状腺结节恶性率高于40岁以上女性(90.7%vs 70.3%,P<0.05),但淋巴结转移率差异无统计学意义(P>0.05)。女性双侧甲状腺结节的恶性率明显高于单侧(88.5%vs 60.7%,P<0.01)。结论性别、年龄、甲状腺结节分布特点可作为甲状腺结节诊断及术前评估的重要参考指标,可为患者选择针对性治疗方式提供参考依据。

Objective To analyze the clinical and pathological data of patients after thyroidectomy for thyroid nodules and explore the characteristics of malignant thyroid nodules and its guiding significance for clinical diagnosis and treatment.Methods Clinical data of 177 patients who underwent thyroidectomy for thyroid nodules admitted to Jiangsu Province Hospital of Chinese Medicine from January 2019 to June 2021 were collected.All patients underwent unilateral thyroidectomy,total thyroidectomy,or radical lymph node dissection according to their conditions.A retrospective analysis was conducted on the clinical data,postoperative pathology,and lymph node metastasis status of the patients.Results Among 177 patients with thyroid nodules,there were 43 males(24.3%)and 134 females(75.7%),but there was no significant difference in the malignancy rate and lymph node metastasis rate between men and women(72.1%vs 76.9%,51.6%vs 52.4%,P>0.05).There was no significant difference in the malignancy rate of thyroid nodules between men and women aged 20-40 years,but the lymph node metastasis rate in men of this age group was significantly higher than that in women(69.2%vs 35.9%,χ^(2)=4.392,P<0.05).There was no significant difference in the malignancy rate and lymph node metastasis rate of thyroid nodules between men and women aged over 40 years(P>0.05).There was no significant difference in the malignancy rate of thyroid nodules between men aged over 40 years and those aged 20-40 years,but the former has a lower lymph node metastasis rate(69.2%vs 33.3%,P<0.05).The malignancy rate of thyroid nodules in women aged 20-40 years was higher than that in women aged over 40 years(90.7%vs 70.3%,P<0.05),but there was no significant difference in the lymph node metastasis rate(P>0.05).The malignancy rate of bilateral thyroid nodules in women was significantly higher than that of unilateral ones(88.5%vs 60.7%,P<0.01).Conclusion Gender,age,unilateral or bilateral nodules can serve as important reference indicators for the diagnosis and preoperative evaluation of thyroid nodules,and can be used as a reference for patients to choose targeted treatment options.