结节性甲状腺肿合并甲状腺癌临床观察

谢莉

[摘要]目的观察并分析结节性甲状腺肿合并甲状腺癌的临床病理特征、诊断方式、治疗措施以及预后。方法将2008～2012年间我院收治40例结节性甲状腺肿合并甲状腺癌患者的临床资料为回顾性分析依据。结果结节性甲状腺肿合并甲状腺癌发病率为13.11%（40/305），所有患者均行手术治疗，40例甲状腺癌患者均经术中冰冻切片病理学检查确诊。术后有2例复发，行再次手术治疗，术后无一例出现死亡，预后效果良好。结论应警惕单侧孤立结节或钙化的甲状腺结节恶变可能性，积极进行手术治疗，可避免甲状腺癌的遗漏，也可做到尽早发现，尽早治疗。术后以甲状腺素作替代性治疗，可有效避免疾病复发。

[关键词] 结节性甲状腺肿；甲状腺癌；病理特征；诊断方式；治疗措施

[中图分类号] R736.1   [文献标识码] B   [文章编号] 2095-0616（2014）09-191-03

Clinical observation of nodular goiter with thyroid cancer

XIE Li

Department of General Surgery, the First College of Clinical Medical Science, Sanxia University, Yichang Central People's Hospital, Yichang 443000,China

[Abstract] Objective To observe and analyze the clinical pathological characteristics, diagnostic methods, treatment measures and prognosis of nodular goiter with thyroid cancer. Methods The clinical materials of 40 cases of patients of nodular goiter with thyroid cancer in our hospital from 2008 to 2012 were selected and retrospectively analyzed. Results The nodular goiter with thyroid cancer incidence rate was 13.14%(40/305), and all the patients were given surgical treatment.The 40 cases of thyroid cancer patients were determined with intraoperative frozen section pathology. There were two cases of recurrence after surgery, reoperation line, no case of death after surgery, and the prognosis was good. Conclusion We should be wary of unilateral solitary nodule or calcification of the possibility of m alignant thyroid nodules, achieve active surgical treatment, which can avoid missing thyroid cancer, early detection and early treatment. In the surgery, to instead with the thyroxine can effectively prevent disease recurrence.

[Key words] Nodular goiter;Thyroid cancer;Pathology;Diagnosis;Treatment

结节性甲状腺肿的病因与单纯性甲状腺肿基本相似，其病变实质上为单纯性甲状腺肿的晚期表现[1-3]，某些结节性甲状腺肿由于上皮细胞增生过度，可诱发胚胎性腺瘤、乳头状腺癌，亦可发展成为甲状腺癌。结节性甲状腺肿合并甲状腺癌时往往难以诊断，临床多采用手术治疗,术前彩超、针吸细胞学检查或术中病理组织冰冻切片检查对于术式的选择具有重要的指导意义[4-7]。本文笔者选取于我院以手术治疗的结节性甲状腺肿合并甲状腺癌患者的临床资料为探究依据，现将临床资料经验总结如下。

1 资料与方法

1.1 一般资料

2008～2012年间我院共收治结节性……