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目的探讨分化型甲状腺癌术前正确诊断和合理手术术式选择。方法对39例分化型甲状腺癌再次手术的临床资料进行回顾性分析。结果术前28例误诊为甲状腺瘤,8例误诊为结节性甲状腺肿。首次手术行单纯性肿瘤切除30例,患叶甲状腺次全切除6例,行腺叶加峡部切除3例。术前、术中32例未做细胞及病理学检查。结论对甲状腺结节患者,应行细针穿吸(FNAC)及术中冰冻切片(FS)检查。并重视区域淋巴结的检(探)查,以确定分化型甲状腺癌诊断,根据病期选择手术术式。如无条件行FNAC及FS,对一叶单发或多发甲状腺结节的可疑病例,宜选择甲状腺叶加峡部切除术术式治疗。
Objective To investigate the correct preoperative diagnosis and rational surgical selection of differentiated thyroid cancer. Methods The clinical data of 39 cases of differentiated thyroid cancer reoperation were analyzed retrospectively. Results 28 cases were misdiagnosed as thyroid tumor before operation and 8 cases were misdiagnosed as nodular goiter. The first operation of simple tumor resection in 30 cases, subtotal thyroidectomy in 6 cases, gland lobectomy and lobectomy in 3 cases. Preoperative and intraoperative 32 cases did not do cell and pathological examination. Conclusion For patients with thyroid nodules, fine needle aspiration (FNAC) and intraoperative frozen section (FS) should be performed. And pay attention to regional lymph node examination (exploration) to determine the diagnosis of differentiated thyroid cancer, surgical procedures based on the stage of choice. If unconditional FNAC and FS, a single or multiple thyroid nodules in a suspicious cases, should choose thyroid lobectomy resection surgical treatment.