CAJ | 학술논문

目的探讨超声辅加绘图定位甲状腺微小结节的临床应用价值。方法对88例甲状腺微小结节（长径≤1．0 cm）患者术前分组（超声绘图定位组和对照组）行常规超声检查。其中超声绘图定位组46例，术前行甲状腺超声检查辅加绘图定位微小结节；对照组42例，术前仅行甲状腺超声检查，不绘图。对两组患者术前超声检查、术中结节切除及术后病理和超声随访结果进行综合分析。结果88例（137个）甲状腺微小结节术前超声诊断与病理诊断符合率为81．8％（69/88）。两组患者术前和术后检查结果：（1）绘图组46例，术前超声显示甲状腺微小结节68个，依据术前超声检查提示及绘图定位的结节位置，术中均快速准确完整切除甲状腺微小结节，病理检查及术后超声复查证实46例（100％，46/46）患者甲状腺微小结节全部切除无一例肿瘤残留。（2）对照组42例，术前超声显示甲状腺微小结节69个，依据术前超声提示的结节位置术中切除了38例（90．5％，38/42）患者的甲状腺微小结节，术后超声复查证实4例（9．5％，4/42）患者术后仍有恶性征象甲状腺微小结节残留。结论术前超声辅加绘图定位对指导临床医师制订手术方案，术中快速、准确切除甲状腺微小结节，减少术后肿瘤残留有重要临床应用价值。
목적탐토초성보가회도정위갑상선미소결절적림상응용개치。방법대88례갑상선미소결절（장경≤1．0 cm）환자술전분조（초성회도정위조화대조조）행상규초성검사。기중초성회도정위조46례，술전행갑상선초성검사보가회도정위미소결절；대조조42례，술전부행갑상선초성검사，불회도。대량조환자술전초성검사、술중결절절제급술후병리화초성수방결과진행종합분석。결과88례（137개）갑상선미소결절술전초성진단여병리진단부합솔위81．8％（69/88）。량조환자술전화술후검사결과：（1）회도조46례，술전초성현시갑상선미소결절68개，의거술전초성검사제시급회도정위적결절위치，술중균쾌속준학완정절제갑상선미소결절，병리검사급술후초성복사증실46례（100％，46/46）환자갑상선미소결절전부절제무일례종류잔류。（2）대조조42례，술전초성현시갑상선미소결절69개，의거술전초성제시적결절위치술중절제료38례（90．5％，38/42）환자적갑상선미소결절，술후초성복사증실4례（9．5％，4/42）환자술후잉유악성정상갑상선미소결절잔류。결론술전초성보가회도정위대지도림상의사제정수술방안，술중쾌속、준학절제갑상선미소결절，감소술후종류잔류유중요림상응용개치。
Objective To explore the clinical significance of preoperative ultrasound-assisted drawings in location of thyroid micronodule resection .Methods A total of 88 patients ( 137 nodules ) who underwent thyroid micro-nodule resection were enrolled in the prospective randomized controlled study .All patients were randomly divided into two groups:46 patients (68 micronodules) in experimental group and 42 patients (69 micronodules) in control group.Inclusion criteria:the maximum diameter of nodule≤1.0 cm. Preoperative thyroid ultrasound was conducted .Patients in experimental group also underwent ultrasound-assisted location of thyroid micronodule .Results The diagnostic accuracy rate of US was 81.82%(69/88) in all patients .With the help of ultrasound-assisted location , all nodules in experimental group were found quickly and accurately.The resection rate of experimental group was 100%(46/46).Whereas 4 nodules (in 4 patients ) were missed in control group with a resection rate of 90.5% (38/42).The postoperative US examinations after 3 months showed that all nodules were completely removed in experimental group while 4 nodules retained in control group .Conclusions Preoperative ultrasound-assisted drawings in location of thyroid micronodule plays an important role in thyroid nodule resection .It is great value of clinical application .