良性甲状腺结节自然病程的B超随访  

Ultrasound Follow-up of Benign Thyroid Nodules in the Course of Natural Disease

作　　者：李燕云 邹大中[1] 陈华[1] 徐宁 郭晓珍[1] 黄文龙[1] LI Yanyun;ZOU Dazhong;CHEN Hua;XU Ning;GUO Xiaozhen;HUANG Wenlong(Jiangyin People's Hospital,Jiangsu Province,Jiangyin 214400,China;不详)

机构地区：[1]江苏省江阴市人民医院,江苏江阴214400

出　　处：《中国医学创新》2023年第5期156-162,共7页Medical Innovation of China

摘　　要：目的:回顾性分析良性甲状腺结节在彩色多普勒超声下的变化情况,了解良性甲状腺结节的分布情况,以及其在不过多医疗干预下的自然病程发展。方法:选取2019年6-9月在江阴市人民医院行甲状腺彩色多普勒超声复查的TI-RADS分级2、3级的甲状腺患者,追溯随访其最早的甲状腺超声检查及期间结节复查情况。分析甲状腺结节的性别比、年龄构成比,以及结节大小、回声、钙化、恶变率等的变化情况。结果:本研究共调查249例甲状腺结节患者,其中男36例,女213例。随访年限最长4.58年,最短9个月,中位数1.93年。40岁以后不管男性、女性,结节的发病率均呈上升趋势。不同病程的甲状腺结节的大小、回声、体积变化差异均无统计学意义(P>0.05)。相关分析发现不同病程的甲状腺结节大小变化与性别、年龄、回声均无相关性(P>0.05)。对甲状腺微小结节(直径<10 mm)进行单独分析,其发病率随着年龄的增长逐渐升高,40岁之后高发,女性的发病率明显高于男性。甲状腺微小结节在随访过程中体积增长,差异有统计学意义(P<0.05)。相关分析结果显示性别、年龄、回声与结节大小变化并无明显相关性(P>0.05)。17例患者在随访过程中接受手术治疗,8例术后病理示恶性(甲状腺乳头状癌),恶性率3.2%。恶变的甲状腺结节有不同程度的回声改变。结论:甲状腺结节生长缓慢,恶性率较低,对于超声显示良性的、无手术指征的甲状腺结节,建议随访观察。随访过程中超声提示甲状腺结节回声改变,应引起临床医生的重视。Objective:To retrospectively analyze the changes of benign thyroid nodules under ultrasound,and find out the distribution of thyroid nodules and the progress of the natural course of disease without excessive medical intervention.Method:Thyroid patients with grade 2 and grade 3 TI-RADS who underwent thyroid color Doppler ultrasonography in Jiangyin People’s Hospital from June to September 2019 were selected to trace their earliest thyroid ultrasonography and nodular reexamination during this period.Changes in sex ratio,age composition ratio,nodule size,echo,calcification and malignant rate of thyroid nodules were analyzed.Result:A total of 249patients with thyroid nodules TI-RADS grade 2,3 were investigated in this study,including 36 males and 213females.The longest follow-up time was 4.58 years and the least time was 9 months,and the median was 1.93 years.After the age of 40,the incidence of nodules in both men and women was escalate.The changes in size,echo,and volume of thyroid nodules in different courses were not statistically significant(P>0.05).Correlation analysis found that there were no correlations between changes in thyroid nodule size and gender,age,and echo in different courses(P>0.05).The incidence of microthyroid nodules(<10 mm in diameter)gradually increases with age,and it was more frequent after the age of 40.The incidence was significantly higher in women than in men.Thyroid nodules increased in volume during follow-up,the difference was statistically significant(P<0.05).The analysis showed that there were no significant correlations between nodule size changes and gender,age,echo(P>0.05).17 patients underwent surgical treatment during following-up,8 patients showed pathological malignancy(papillary thyroid carcinoma)after surgery,the malignant rate was 3.2%.Malignant thyroid nodules had different degrees of echogenic changes.Conclusion:Thyroid nodules grow slowly and have a low malignancy rate,follow-up observation is recommended for benign thyroid nodules.During follow-up,the echo changes

关 键 词：良性甲状腺结节 甲状腺癌 超声 

分 类 号：R581[医药卫生—内分泌]