结节性甲状腺肿合并甲状腺微小癌的诊断与治疗

目的：总结结节性甲状腺肿合并甲状腺微小癌的诊治经验。方法：回顾性分析2001年1月至2007年3月收治的42例结节性甲状腺肿合并甲状腺微小癌的临床资料。结果：同期手术治疗结节性甲状腺肿患者836例，合并甲状腺微小癌42例（42／836，5．02％），其中术前诊断3例。所有患者均行术中快速冷冻病理检查，并根据病理检查结果采取不同的手术方式。术中冰冻病理结果微小癌39例（92．9％），其中乳头状癌37例，滤泡状癌2例；术后石蜡病理切片证实42例，其中乳头状癌40例，滤泡状癌2例。结论：结节性甲状腺肿临床中常见，但并发甲状腺微小癌时术前诊断困难，术中快速冷冻病理检查有利于选择正确的手术方式，使治疗更加合理有效。

An analysis on 42 cases with nodulargoiter combined with thyroid microcarcinoma

Objective:To explore the clinical experience to treat nodulargoiter combied with thyroid microcarcinoma.Methods:From 2001 to 2007,42 patients with nodulargoiter combied with thyroid microcarcinoma were treated in our hospital,their clinical data was analysed retrospectively.Results:In 836 patients with nodulargoiter,thyroid carcinoma was 42(5.02%),3 cases were found before operation.All patients had accepted rapid frozensection intraoperation,and selected appropriate operative methods according to pathological results.Conclusion:Nodulargoiter is a common disease,but discovering thyroid microcarcinoma in preoperation is difficult.The rapid frozen section intraoperation can help us to select correct operative methodst.