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从1983年1月到1985年11月共收治甲状腺结节372例,在临床分析的基础上重点讨论甲状腺癌的诊断和治疗。本组男79例、女293例,最小年龄15岁,最大年龄72岁。甲状腺瘤252例,结节性甲状腺肿114例。187例病检中,11例为甲癌,占5.8%。对甲状腺单发结节伴有生长迅速,质硬,扫描为冷结节,吸Ⅰ率低或早期出现压迫症状者,要高度怀疑甲状腺癌。最有效的诊断方法是穿刺活检和术中冰冻检查。甲癌治疗以手术为主,其术式直接影响预后。我们认为包膜完整无淋巴结肿大的甲癌,作患侧及峡部甲状腺切除加健侧内侧切除,不必作淋巴结扩清;对包膜不完整或淋巴结肿大者,应在广泛切除基础上加改良淋巴结扩清。
From January 1983 to November 1985 a total of 372 cases of thyroid nodules were treated, based on the clinical analysis focused on the diagnosis and treatment of thyroid cancer. The group of 79 males and 293 females, the youngest age of 15 years, the maximum age of 72 years. 252 cases of thyroid tumors, nodular goiter in 114 cases. Among the 187 cases examined, 11 cases were A, accounting for 5.8%. Thyroid single nodules accompanied by rapid growth, hard, scanning for cold nodules, low rate of Ⅰ or early symptoms of oppression, should be highly suspected thyroid cancer. The most effective diagnostic methods are biopsy and intraoperative frozen examination. Treatment of cancer-based surgery, its direct impact on prognosis. We believe that the complete capsule without lymph node enlargement of the cancer, for ipsilateral and isthmic thyroid resection plus Jian medial resection, lymph node dissection need not be expanded; incomplete capsule or enlarged lymph nodes should be based on extensive excision Improved lymph node dissemination.