桥本病合并甲状腺微小癌的外科诊治（附11例报告）  

The diagnosis and treatment of Hashimto＇s disease with thyroid microcarcinoma （ 11 cases report）

作　　者：吴维敏[1] 余书勇[1] 尹俊峰[1] 周振环[1] 涂瑞纱[1] 肖宁[2] 

机构地区：[1]海南省海口市解放军187中心医院普通外科,海口571159 [2]海南省海口市解放军187中心医院特诊科,海口571159

出　　处：《内分泌外科杂志》2008年第6期376-378,共3页

摘　　要：目的探讨桥本病合并甲状腺微小癌的外科诊治和尽量避免二次手术。方法分析1990年3月～2008年3月收治的85例桥本病中合并甲状腺微小癌的11例的外科诊治及其预后。结果本组桥本病与甲状腺微小癌的并存率为12．94％（11／85），术前确诊3例；术中明确诊断5例；术后病理确诊3例，其中2例行第二次手术，1例补切患侧残余腺体，另1例除补切患侧残余腺体外并加功能性淋巴结清扫。术后随访2个月～15年，1例再手术后无复发。结论桥本病合并甲状腺微小癌术前确诊困难，术前应详细触诊，桥本病患者合并甲状腺结节者应常规作术中快速冰冻切片检查，甲状腺叶全切或次全切、术后服用小剂量的甲状腺素片对治疗有良好的临床效果。Objective To investigate the diagnosis and treatment of Hashimto＇s disease patients with thyroid microcarcinoma. Methods 11 Hashimto＇s disease patients with thyroid microearcinoma out of Hashimto＇s disease patients from March 1990 to March 2008 were analyzed. Result The intereurrent probability of HD and TMC is 12.94% （11/85）. 3 patients have been diagnosed before surgery. 5 patients have been diagnosed during surgery. 3 patients have been diagnosed after surgery. Conclusion Hashimto＇s disease patients with thyroid microcarcinoma were difficulty to be diagnosed before surgery. Frosen section for the sample is recommended.

关 键 词：桥本病 甲状腺微小癌 诊断 治疗 

分 类 号：R65[医药卫生—外科学] R73[医药卫生—临床医学]