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目的:研究结节性甲状腺肿伴发微小恶性肿瘤的临床诊治方法;方法:对2006年1月~2010年1月在我院接受治疗的结节性甲状腺肿患者18例的病历资料进行回顾性分析。结果:男1例(5.56%),女17例(94.44%),所有18例(100%)患者均为乳头状恶性肿瘤,13例(72.22%)术中冰冻切片检查、5例(27.78%)患者术后石蜡切片提示结节性甲状腺肿伴发微小恶性肿瘤,所有患者均行手术治疗,单侧患者行甲状腺腺叶并峽部切除术治疗,双侧患者行甲状腺大部切除术并峽部切除术治疗。术后均给予口服左旋甲状腺素片或者甲状腺素片。术中均未伤及喉返神经,也未发生与手术相关的并发症。随访30d~5年期间患者全部存活,存活率为100%,复查未见肿瘤复发或转移;结论:结节性甲状腺肿伴发微小恶性肿瘤无特异性特征,术前难以诊断,术中冷冻病理检查能够帮助选择正确有效的手术方式,提高治疗效率。
Objective: To study the clinical diagnosis and treatment of nodular goiter associated with small malignant tumors. Methods: The clinical data of 18 patients with nodular goiter who were treated in our hospital from January 2006 to January 2010 were retrospectively reviewed analysis. Results: There were 1 case (5.56%) of males and 17 females (94.44%), all 18 cases (100%) were papillary malignant tumors. Thirteen (72.22% ) Patients with paraffin section after surgery tips nodular goiter with micro-malignant tumors, all patients underwent surgical treatment of unilateral thyroid gland lobectomy and thyroidectomy, bilateral thyroidectomy and partial gastrectomy Partial resection treatment. All patients were given oral levothyroxine tablets or thyroxine tablets. No intraoperative recurrent laryngeal nerve injury, surgery-related complications have not occurred. All patients survived 30 days to 5 years follow-up with a survival rate of 100%. No tumor recurrence or metastasis was found in the review. CONCLUSIONS: Nodular goiter with small malignant tumor has no specific characteristics and is difficult to diagnose before surgery. Intraoperative frozen pathology Check can help select the correct and effective surgical methods to improve the efficiency of treatment.