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目的探讨甲状旁腺腺瘤合并甲状腺结节的诊断及外科治疗方法。方法回顾性分析我院收治的34例甲状旁腺腺瘤合并甲状腺结节的临床诊治经验。结果甲状旁腺腺瘤单侧单发多见(3l/34),单侧甲状旁腺腺瘤合并同侧甲状腺结节多见(25/31)。甲状腺结节病变性质主要为结节性甲状腺肿(27/34)。34例均行外科手术治疗。术后早期有8例患者出现短时的低钙血症,余无明显并发症。术后随访26例,全部患者甲状旁腺腺瘤均无明显复发迹象,结节性甲状腺肿患者有2例术后复查再次发现甲状腺结节,均予以动态观察,未行进一步手术切除,其余病例甲状腺结节均无复发。结论手术切除是治疗甲状旁腺腺瘤合并甲状腺结节的最有效的方法,最常用手术方式为单侧颈部探查术,术前定性及定位诊断结合术中诊断是手术成功的关键。
Objective To investigate the diagnosis and surgical treatment of parathyroid adenoma with thyroid nodules. Methods Retrospective analysis of 34 cases of parathyroid adenoma treated thyroid nodules in our hospital clinical experience. Results Single parathyroid adenoma was more common (3l / 34), unilateral parathyroid adenoma with ipsilateral thyroid nodules more common (25/31). Thyroid nodules mainly nodular goiter disease (27/34). 34 patients underwent surgical treatment. In the early postoperative period, 8 patients had short-term hypocalcemia, but no obvious complication. All patients were followed up for 26 cases. All the patients had no obvious recurrence of parathyroid adenoma. Two patients with nodular goitre were found to have thyroid nodules again after the operation, all of them were dynamically observed without further surgical resection. The remaining cases No recurrence of thyroid nodules. Conclusions Surgical resection is the most effective method to treat parathyroid adenoma with thyroid nodule. The most common surgical method is unilateral cervical exploration. Preoperative diagnosis and positioning diagnosis combined with intraoperative diagnosis are the keys to successful operation.