目的:探讨甲状腺乳头状癌的诊断及并发症的处理。方法:回顾性分析1995-2004年南昌大学第二附属医院经手术和病理证实的136例甲状腺乳头状癌的临床资料。结果:术中冰冻切片诊断符合率为98.2%（111/113），显著高于术前B超、CT和细针穿刺细胞学检查，上述三者的正确诊断率分别为25.8%（16/62）、80.0%（24/30）和78.1%（25/32）。术后低钙血症、喉返神经麻痹及乳糜漏的发生率分别为8.8%（12/136）、2.2%（3/136）和1.5%（2/136）。结论:术中冰冻快速切片是诊断甲状腺乳头状癌的可靠依据；胸导管漏口-大隐静脉-颈内静脉搭桥吻合术是治疗高流量乳糜漏的好方法。

Objective:To evaluate the diagnosis and the treatment of thyroid papillary carcinoma and its complications. Methods:The clinical data of 136 cases of thyroid papillary carcinoma confirmed by surgery and pathology from 1995 to 2004 in the Second Affiliated Hospital of Nanchang University were analyzed retrospectively. Results:The coincidence rate of diagnosis for thyroid papillary carcinoma by intraoperative frozen section was 98.2% (111/113).It was significantly higher than that by ultrasonography (25.8%,16/62),CT (80.0%,24/30) and fine needle aspiration biopsy (78.1%,25/32).Hypocalcemia after surgical event could be documented in 8.8% of 136 cases,recurrent laryngeal nerve injury in 2.2% of cases and chyle leakage in 1.5% of cases. Conclusion:The intraoperative frozen section can provide reliable evidence for the diagnosis of thyroid papillary carcinoma. The peripheral tissues of thoracic duct fistulagreat saphenous veininternal jugular vein anastomosis is a good way to treat high flow of chyle transudation.