Objective To explore the application value of intraoperative ultrasound on small thyroid nodules resection. Methods Thirty-seven inpatients who underwent thyroid nodule resection ( a total of 48 nodules) were included in this study. These thyroid nodules were small in size (the maximum diameter less than or equal to 2 centimeter) and should not cause regional eminence of thyroid capsule . Preoperative thyroid ultrasound was conducted with the focus on following observations of the nodules : the shape , size, number, boundary, internal echo , calcification , halo, vascularity , and the relationship with surrounding tissues , especially the distances between nodule and capsule , trachea, carotid artery, and the upper or lower pole of the gland. In operation ,the specialized intraoperative ultrasound probe was used to accurately locate and guide nodule resection , and observe whether the nodule was completely removed . Results During the surgical procedures , 16 nodules could be found by palpation , and intraoperative ultrasound was used for further confirmation. Other 32 nodules were not palpated clearly due to the deep location or soft constitution . Intraoperative ultrasound was used for guidance. All these nodules were completely removed. The postoperative examinations after a month showed that all nodules of interest were completely resected and no hypothyroidism was found. Conclusions Intraoperative ultrasound plays an important role in thyroid nodule resection. It makes surgical procedure more accurate and could prevent missed resection and the occurrence of postoperative hypothyroidism , which has the value of clinical application .%目的 探讨术中超声在甲状腺小结节切除术中的应用价值.方法 我院37例拟行甲状腺结节切除术的患者(共48个结节),纳入标准为未凸出甲状腺包膜的小结节(最大长径≤2.0 cm),术前对甲状腺结节进行常规超声检查,初步明确结节的形态、大小、数量、边界、内部回声、钙化、低回声晕、血液供应、与邻近组织关系等特征,尤其是结节与邻近组织的关系,如距腺体表面距离、距内侧缘气管距离、距外侧缘颈动脉距离、距甲状腺腺体上下极距离等;术中应用专用术中超声探头对甲状腺结节进行精确的术中定位,指导手术操作,并确定术后结节是否完全切除.结果 16个结节靠外科术者术中触诊可大致确认位置,并利用超声扫查进一步确认;另32个结节由于位置较深或质地较软,触诊不明确,均在术中超声指导下定位.借助术中超声的实时引导和监测,所有甲状腺拟切除结节均完全切除.术后1个月超声复查,已切除的甲状腺结节均未检出残留,均未出现甲状腺功能减低.结论 术中超声对未凸出甲状腺腺体表面的小结节切除术具有指导作用,使手术操作更精确,防止结节漏切,并能避免术后甲状腺功能减低的发生,值得临床广泛推广.
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