【摘要】 目的:探讨结节性甲状腺肿合并甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)的临床特征及诊治方法。方法:回顾性分析79例结节性甲状腺肿合并PTMC病例的临床资料。结果:56例术前B超检查考虑PTMC可能,64例经术中冰冻病理诊断,15例经术后石蜡切片证实。55例行单侧腺叶+峡部切除,清扫同侧中央区淋巴结;全甲状腺切除9例,清扫双侧中央区淋巴结。18例单侧中央区淋巴结转移(22.8%),术后并发暂时性喉返神经麻痹5例,暂时性甲状旁腺功能减退6例,并发症发生率13.9%。结论:结节性甲状腺肿为临床常见病,术前B超检查、术中冰冻病检有利于提高伴发PTMC的诊断率,PTMC中央区淋巴结转移率高,预防性清扫中央区淋巴结是必要的。更多还原

【Abstract】 Objective: To explore the clinical characteristics,diagnosis and treatment of nodular goiter coexistent combined with papillary thyroid microcarcinoma(PTMC).Methods: The clinical data of 79 nodular goiter combined with PTMC were studied retrospectively.Results: 56 cases were diagnosed PTMC by B mode sonography preoperation,64 cases were diagnosed by rapid frozen section intraoperation,15 cases were confirmed by paraffin section after operation.Among the 79 patients,55 patients underwent lobectomy with isthmectomy and ipsilateral central lymph node(CLN) dissection,while 9 patients have received total thyroidectomy with bilateral CLN excision.The total rates of CLN metastasis was 22.8%(18/79).The occurrence rates of complication was 13.9%(11/79).Conclusions: Nodular goiter was a common disease,B-mode sonography and rapid frozen section improve the diagnosis rate of PTMC.Metastasis in CLN of PTMC were relatively common,it was necessary for prophylactic central lymph node dissection.更多还原