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Clinical Analysis of Nodular Goiter

Author: ZhuSiWei
Tutor: WangZhiMing
School: Central South University
Course: General Surgery
Keywords: Nodular goiter With thyroid cancer Surgery Complication
CLC: R581.3
Type: Master's thesis
Year: 2008
Downloads: 271
Quote: 1
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Abstract


Objective: To understand the clinical features of nodular goiter , improve the rate of correct diagnosis in the preoperative and intraoperative analyzed surgical indications , clear the best surgical approach and scope , and reduce the incidence of postoperative complications discussed about the nodules goiter with thyroid cancer . Methods: From January 2005 to December 2007 were retrospectively analyzed clinical data in of Xiangya Hospital general surgical resident nodular goiter surgery patients during the statistical analysis of the data using SPSS10.0 software . Results: The proportion of men and women in the group of patients to 1:5.7 , the average age of 46 ± 12 years . B super multi nodules 308 cases , 72.8 % , 273 cases of nodular thyroid located in bilateral (64.5%) ; simple nodular goiter nodular goiter with thyroid cancer was significantly higher than in the B- calcification incidence ; swollen thyroid cancer patients with 39 cases of B-ultrasound results show cancer in unilateral solitary nodule in 24 cases (61.5 %) . Nodular goiter with thyroid cancer TGA positive rate was significantly higher than nodular goiter . Preoperative correct diagnosis of nodular goiter rate was 82.8% , while the correct diagnosis of nodular goiter with thyroid cancer only 10% ( 4 / 40 ) . Line thyroid lobe ipsilateral subtotal resection of 93 cases (21%) , accounting for 75.1% of the 332 cases of thyroid lobe ipsilateral resection , both no statistical difference in the incidence of postoperative complications ; reoperation for postoperative complications the incidence ( 6 / 49 ) was significantly higher than the first surgery ( 14 / 393 ) ; surgery has not been revealed postoperative recurrent laryngeal nerve stroke hoarseness incidence ( 5 / 82 ) was significantly higher than the surgery revealed recurrent laryngeal nerve stroke ( 3 /360) . 40 patients with thyroid cancer among the 39 cases of intraoperative frozen section biopsy found cancer , 97.5% accuracy rate . Conclusion: ① nodular goiter in B- calcification , calcification whether or gravel , should be alert to the merger may be malignant , prompt surgical treatment . ② unilateral solitary nodule bilateral multiple nodules should be noted , wary of its merger may be malignant . ③ nodular goiter surgery should pay attention to the first surgery , intraoperative recurrent laryngeal nerve exploration , in order to reduce the incidence of postoperative complications . The ④ surgery should be routinely performed quick pathological examination of the frozen section .

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Thyroid disease > Goiter
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