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目的探讨甲状腺微小乳头状癌(PTMC)的诊断、手术方式及治疗效果。方法回顾分析自2004年1月至2009年6月病理证实的PTMC89例患者的临床资料。结果术前均行超声检查,拟诊PTMC58例(65.17%)。89例中行患侧甲状腺+峡部甲状腺全切除63例,患侧甲状腺全切+对侧甲状腺次全切除17例,甲状腺全切除9例。23例行患侧中央区淋巴结清扫术,6例术后病理证实有淋巴结转移;其中3例同时行功能性淋巴结清扫术,术后病理证实均有淋巴结转移。术后1例复发。结论超声可明显提高甲状腺乳头状微小癌的检出率,患侧腺叶+峡部甲状腺全切除是可行的,同期中央区淋巴结清扫是必要的。
Objective To investigate the diagnosis, operation and treatment of thyroid papillary carcinoma (PTMC). Methods The clinical data of 89 patients with pathologically confirmed PTMC from January 2004 to June 2009 were retrospectively analyzed. Results All patients underwent ultrasonography preoperatively and 58 cases (65.17%) were diagnosed with PTMC. 89 patients underwent lateral thyroidectomy + isthmic thyroid resection in 63 cases, ipsilateral thyroidectomy + contralateral thyroid subtotal resection in 17 cases, total thyroidectomy in 9 cases. 23 cases of ipsilateral central lymph node dissection, 6 cases of postoperative pathology confirmed lymph node metastasis; 3 cases of simultaneous functional lymph node dissection, postoperative pathology confirmed lymph node metastasis. One patient recurred after operation. Conclusion Ultrasound can significantly improve the detection rate of thyroid papillary microcarcinoma, ipsilateral lobectomy thyroidectomy is feasible, the same period, central lymph node dissection is necessary.