【摘要】：目的:分析40歲以上患者甲狀腺結(jié)節(jié)病變特點(diǎn),評(píng)價(jià)術(shù)前超聲、細(xì)針穿刺抽吸活檢診斷甲狀腺結(jié)節(jié)的價(jià)值。方法:收集貴陽醫(yī)學(xué)院附屬醫(yī)院甲狀腺外科2011年2月~2013年12月行甲狀腺結(jié)節(jié)手術(shù)治療且年齡≥40歲患者533例病歷資料,整理患者年齡、性別及病理類型和甲狀腺結(jié)節(jié)良惡性的構(gòu)成,分析術(shù)前促甲狀腺激素水平與甲狀腺結(jié)節(jié)良惡性關(guān)系;以術(shù)后病理結(jié)果為標(biāo)準(zhǔn)評(píng)價(jià)患者術(shù)前超聲、細(xì)針穿刺抽吸活檢診斷的準(zhǔn)確性;以結(jié)節(jié)良惡性為因變量采用多因素logistic回歸分析方法預(yù)測甲狀腺惡性結(jié)節(jié)的危險(xiǎn)因素。結(jié)果:(1)40~59歲年齡段好發(fā)甲狀腺結(jié)節(jié),男女之比為1:5.92;(2)甲狀腺結(jié)節(jié)男、女惡性率分別為23.4%、13.6%;(3)甲狀腺結(jié)節(jié)病理類型中結(jié)節(jié)性甲狀腺腫和腺瘤占68.3%,甲狀腺乳頭狀癌占13.5%,其余甲狀腺濾泡癌、髓樣癌及其他占1.6%;(4)單發(fā)、實(shí)性、大結(jié)節(jié)惡性率高于多發(fā)、混合性結(jié)節(jié),囊性結(jié)節(jié)惡變性較低;(5)術(shù)前超聲、細(xì)針穿刺抽吸活檢診斷與術(shù)后病理結(jié)果對(duì)比符合率分別為82.8%、94.9%;(6)隨著TSH水平增高惡性結(jié)節(jié)比例隨之增加。結(jié)論:40歲以上甲狀腺結(jié)節(jié)患者惡性率男性高于女性,術(shù)前超聲、細(xì)針穿刺抽吸活檢在結(jié)節(jié)良惡性鑒別上有重要的診斷價(jià)值。
[Abstract]:Objective: to analyze the characteristics of thyroid nodule lesions in patients over 40 years old and evaluate the value of preoperative ultrasound and fine needle aspiration biopsy in the diagnosis of thyroid nodules. Methods: from February 2011 to December 2013, 533 patients with thyroid nodules aged more than 40 years were treated by thyroid surgery in affiliated Hospital of Guiyang Medical College. Sex, pathological type and the composition of benign and malignant thyroid nodules, the relationship between preoperative thyroid stimulating hormone levels and benign and malignant thyroid nodules was analyzed, and preoperative ultrasound was used to evaluate the postoperative pathological results. The accuracy of fine needle aspiration biopsy in diagnosis and the risk factors of thyroid malignant nodules were predicted by multivariate logistic regression analysis with benign and malignant nodules as dependent variables. Results: (1) thyroid nodules were common in the age group of 40 to 59 years old, the ratio of male to female was 1: 5.92; (2) the malignant rate of thyroid nodule was 23.4and 13.6in male, and (3) in the pathological type of thyroid nodule, nodular goiter and adenoma were 68.3%, papillary thyroid carcinoma was 13.5th and thyroid follicular carcinoma was other thyroid follicular carcinoma. (4) the malignant rate of single, solid and large nodules is higher than that of multiple, mixed nodules, cystic nodule malignancy is lower. (5) preoperative ultrasound, The coincidence rates of fine needle aspiration biopsy diagnosis and postoperative pathological results were 82.8% and 94.9% respectively. (6) the proportion of malignant nodules increased with the increase of TSH level. Conclusion the malignant rate of thyroid nodule over 40 years old is higher in male than in female. Preoperative ultrasound and fine needle aspiration biopsy have important diagnostic value in differentiating benign and malignant nodules.
【學(xué)位授予單位】：貴陽醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R581

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