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目的:探讨桥本甲状腺炎并存甲状腺微小癌的临床特点、诊治原则,以提高对本病诊断和治疗的认识。方法:回顾性分析福州市第一医院2001~2009年间38例桥本甲状腺炎并存甲状腺微小癌的临床资料。结果:本组患者平均年龄40岁,术前诊断率低,术中快速病理检查漏诊率为13.2%。全部以颈前肿块或高频超声发现癌疑结节为主诉。结论:桥本甲状腺炎合并甲状腺微小癌临床漏诊率较高。术前仔细的触诊,和术中认真探查可疑结节有助于提高临床诊断率。甲状腺叶的全切除或全甲和近全甲切除术治疗桥本甲状腺炎并存甲状腺微小癌具有良好的临床疗效。
Objective: To investigate the clinical characteristics, diagnosis and treatment of Hashimoto’s thyroiditis complicated with thyroid microcarcinoma, in order to improve the diagnosis and treatment of this disease. Methods: The clinical data of 38 patients with Hashimoto’s thyroiditis coexisting with thyroid microcarcinoma from 1998 to 2009 in Fuzhou No.1 Hospital were retrospectively analyzed. Results: The average age of patients in this group was 40 years old, the preoperative diagnosis rate was low, and the rate of missed diagnosis by intraoperative fast pathological examination was 13.2%. All cervical cancer mass or high-frequency ultrasound found suspicious of nodules is the main complaint. Conclusion: Hashimoto’s thyroiditis combined with thyroid microcarcinoma has a higher rate of missed diagnosis. Preoperative careful palpation, and intraoperative careful detection of suspicious nodules will help to improve the clinical diagnosis rate. Full or partial thyroidectomy and total thyroidectomy for the treatment of Hashimoto’s thyroiditis with thyroid microcarcinoma has a good clinical effect.