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目的探讨甲状腺微小癌的诊治经验。方法回顾分析35例甲状腺微小癌的临床资料。结果术前22例超声提示有微小钙化而可疑甲状腺癌,占62.85%,与良性结节5.95%的微钙化率相比差异有统计学意义。术前穿刺6例,确诊4例。术中病冻切片确诊27例,8例术后石蜡切片确诊。8例术后确诊患者未行补救手术,随访2个月~7年,与其余27例患者比较复发率无显著统计学意义。结论彩超所提示的微钙化对论断甲状腺微小癌有意义,术前术中明确诊断的微小癌的手术以腺叶加峡部全切,对侧次全切为宜。术后确诊的微小癌如果已行患侧腺叶次全切或全切,可暂不行补救手术,但应密切观察。有颈淋巴结转移者行功能性颈淋巴结清扫术,对于未触及淋巴结肿大的患者,不宜做预防性颈清扫。
Objective To investigate the diagnosis and treatment of thyroid microcarcinoma. Methods The clinical data of 35 cases of thyroid microcarcinoma were retrospectively analyzed. Results Twenty-two cases were diagnosed with microcalcification and suspected thyroid cancer by ultrasound before operation, accounting for 62.85%. The difference was statistically significant compared with that of benign nodules (5.95%). Preoperative puncture in 6 cases, 4 cases diagnosed. Intraoperative frozen section diagnosis of 27 cases, 8 cases of paraffin sections confirmed. Eight patients who were diagnosed without postoperative recovery surgery, followed up for 2 months to 7 years, with the remaining 27 patients no significant recurrence rate was statistically significant. Conclusions The microcalcification suggested by color Doppler ultrasound is of great value to the diagnosis of thyroid microcarcinoma. The operation of microscopic carcinoma diagnosed preoperatively and intraoperatively is performed with the glandular isthmus and the isthmus. Micro-diagnosed postoperative cancer if the line has been implemented subtotal lobectomy or total cut, can not temporarily remedial surgery, but should be closely observed. Patients with cervical lymph node metastasis functional cervical lymph node dissection, for patients with untreated lymph nodes, should not do preventive neck dissection.