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目的对268例因甲状腺结节住院手术治疗的患者资料进行回顾性分析。方法本组共研究268例于2003年8月至2008年8月在我院外科因甲状腺结节住院手术治疗且甲状腺功能正常的患者,对所有患者的临床、实验室检查及病理资料进行回顾性分析。结果268例中222例为结节性甲状腺肿(83.8%),其中121例为单纯性结节性甲状腺肿,101例为结节性甲状腺肿伴出血、囊性变或腺瘤样增生。恶性肿瘤17例,其中甲状腺乳头状腺癌14例(5.2%),甲状腺滤泡癌2例,甲状腺髓样癌1例。恶性肿瘤患者年龄多在30～49岁,均为查体发现。14例恶性肿瘤超声为低回声实性单结节,6例扫描冷结节。其余病例分别为甲状腺腺瘤、桥本氏病。结论本组甲状腺结节手术病例以良性疾病,尤其结节性甲状腺肿占多数。B超为低回声实性单发结节且扫描为冷结节者恶性可能性大。对无症状且甲状腺功能正常的甲状腺结节,应结合多种辅助检查综合判断结节性质,争取行甲状腺细针抽吸细胞学检查明确诊断,减少良性结节患者不必要的手术。
Objective To retrospectively analyze the data of 268 cases of thyroid nodules hospitalized for surgical treatment. Methods A total of 268 cases of thyroid nodules hospitalized in our hospital from August 2003 to August 2008 were enrolled in this study. Patients with normal thyroid function were retrospectively reviewed. All patients were retrospectively analyzed for clinical, laboratory and pathological data analysis. Results Among the 268 cases, 222 were nodular goiter (83.8%), of which 121 were simple nodular goiter and 101 were nodular goiter with hemorrhage, cystic degeneration or adenoid hyperplasia. Malignant tumors in 17 cases, including thyroid papillary adenocarcinoma in 14 cases (5.2%), thyroid follicular carcinoma in 2 cases, medullary thyroid carcinoma in 1 case. Malignant tumors in patients aged more than 30 to 49 years old, were found in the examination. Fourteen cases of malignant tumor were hypoechoic solid nodules and 6 cases were cold nodules. The remaining cases were thyroid adenoma, Hashimoto’s disease. Conclusion The thyroid nodules in this group of patients with benign diseases, especially nodular goiter accounted for the majority. B ultrasound for low echo real solitary nodules and scan for cold nodules are highly likely malignant. Asymptomatic thyroid nodules with normal thyroid function should be combined with a variety of auxiliary examinations to determine the nature of nodules, for thyroid fine needle aspiration cytology clear diagnosis, reduce unnecessary surgery in patients with benign nodules.