Clinical Analysis Of Nodular Goiter

Objective:To understand the clinical characteristics of nodular goiter,and to increase the diagnostic accuracy before and during the thyroid surgery.To summarize the indication of the operation.To clear the best operative method and the range of operation,and reduce the incidence of postoperative complications.Study the questions for nodular goiter complicated with thyroid carcinoma.Methods:Collect the clinical information of the patients who were admitted to Xiang-ya hospital as nodular goiter from January of 2005 to December of 2007,all the patients had received operation and the pathological diagnosis were shown as nodular goiter.Use SPSS 10.0 to statistical analysis.Results:Male/female ratio is 1:5.7,the mean age is 46±12 years old.B-ultrasound shows that 72.8%patients have multinodular and the nodules of 64.5%patients are in two sides.Compare the rate of calcification in B-ultrasound between nodular goiter complicated with thyroid carcinoma and nodular goiter,nodular goiter complicated with thyroid carcinoma is obviously more than nodular goiter.The B-ultrasound result of patients who had nodular goiter complicated with thyroid carcinoma shows,the canceration of 61.5%patients is in solitary nodule of one side.Compare the positive rate of TGA between nodular goiter complicated with thyroid carcinoma and nodular goiter,nodular goiter complicated with thyroid carcinoma is obviously more than nodular goiter.The correct rate of preoperative diagnosis of nodular goiter is 82.8%,but the correct rate of preoperative diagnosis of nodular goiter complicated with thyroid carcinoma is 10%.93 patients(21%) adopt subtotal resection of lobus glandulae thyroideae,332 patients (75.1%)adopt total resection of lobus glandulae thyroideae;compare the incidence rate of postoperative complications between the two operation methods,it has no statistics contrast.Compare the incidence rate of postoperative complications between repeated operation and first operation,repeated operation is obviously more than first operation. Compare the incidence rate of hoarseness between revealing recurrent laryngeal nerve and not revealing recurrent laryngeal nerve,not revealing recurrent laryngeal nerve is obviously more than revealing recurrent laryngeal nerve.The frozen section of 39 patients who are nodular goiter complicated with thyroid carcinoma found canceration,the correct rate is 97.5%(39/40).Conclusions:①To calcification in B-ultrasound of nodular goiter, no matter whether it is microcalcification,we should operate in time because it is possible complicated with thyroid carcinoma.②To pay attention to solitary nodule of one side among multinodular because it is possible complicated with thyroid carcinoma.③To pay attention to the first operation and reveal recurrent laryngeal nerve in the operation to decrease the incidence rate of postoperative complications.④Frozen section is routine In the operation of nodular goiter.