目的:探讨桥本氏甲状腺炎合并甲状腺癌的临床特征及外科手术治疗原则.方法:回顾性分析54例桥本氏甲状腺炎合并甲状腺癌患者的临床特征、外科手术治疗情况及近期疗效.结果:共收集桥本氏甲状腺炎病例362例,其中桥本氏甲状腺炎合并甲状腺癌54例,发病率为14.9％ (54/362).甲状腺癌患者均进行了适当范围的手术治疗,术后服用优甲乐,随访6个月至4年.1例局部复发,3例发生颈部淋巴结转移,均行二次手术,无死亡病例.结论:桥本氏甲状腺炎合并甲状腺癌患者临床表现缺乏特异性,采用甲状腺抗体检测、彩色多普勒B超检查、CT检查、同位素扫描及细针或粗针穿刺活检的联合检查可提高诊断的准确率.合理的手术方法是治疗桥本氏甲状腺炎合并甲状腺癌的有效手段.%Objective To investigate the clinical characteristics and surgical treatment of Hashimoto's disease complicated with thyroid cancer. Methods Clinical data of 54 patients with Hashimoto's disease complicated with thyroid cancer were retrospectively analyzed, including clinical characteristics, surgical treatment, and short-term effects. Results The rate of Hashimoto's disease complicated with thyroid cancer was 14.9% , 54 out of in 362 patients with Hashimoto's disease. All the 54 patients had surgical treatment in proper thyroid region, took euthyrox after the operation and had 6 month to 4 year followup. One patient had a local recurrence and 3 had lymph node metastasis in the neck, and these 4 patients had second operation on the thyroid gland. No death occurred. Conclusion Hashimoto's disease complicated with thyroid cancer has no typical symptoms. Combined examination of anti-thyroid antibodies test, color doppler imaging, CT detection, isotope scan and core/fine needle biopsy may provide accurate diagnosis. Proper surgical treatment is effective for Hashimoto's disease complicated with thyroid cancer.
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