Abstract:

Paying attention to the standardization of diagnosis and treatment of thyroid nodules        TIAN Wen，YAO Jing. Department of General Surgery，the General Hospital of PLA，Beijing 100048，China
Corresponding author: TIAN Wen，E-mail：tianwen301@sina.com
Abstract    The incidence of thyroid nodules，particularly thyroid cancer，has sharply increased worldwide. Because there are not diagnosis and treatment guidelines about thyroid nodules and thyroid cancer. The diagnosis and treatment of thyroid nodules and thyroid cancer is in the status of disarray. The uncertainty of preoperative examination and the diversity of surgical method will lead to increase the rate of tumor residual and recurrence，and the reoperation rate and the risk of complication will also rise. In view of the status of diagnosis and treatment for thyroid nodules and thyroid cancer in our country，the Chinese version of “thyroid nodules and differentiated thyroid cancer diagnosis and treatment guideline” was released in 2012，which explicitly recommended that every thyroid nodules should undergo ultrasound examination，and suspected malignant thyroid nodules should perform fine needle aspiration biopsy examination. The operative procedures for thyroid cancer include total or near total thyroidectomy，lateral lobectomy and isthmus resection. Surgeons should perform ipsilateral central lymph node dissection after effective protection of recurrent laryngeal nerve and parathyroid. The elements for the diagnosis and treatment of thyroid nodules and differentiated thyroid cancer were discussed systematicly，and standardized the diagnosis and treatment. The purpose is to help surgeon to minimize problems of diagnosis and treatment. So it is highly meaningful for clinical work.

Key words: thyroid nodules；standardization, diagnosis, treatment

摘要：

甲状腺结节特别是甲状腺癌的发病率在全球范围内呈现上升趋势。以往国内由于没有甲状腺结节和甲状腺癌方面的诊治指南，导致甲状腺结节特别是甲状腺癌的诊治处于混乱状态，术前检查不确定和手术方式多样性都会导致肿瘤残留率和复发率的增加，再次手术率明显升高，发生并发症风险增加。针对国内甲状腺结节和甲状腺癌诊治的现状，2012年我国发布了《甲状腺结节和分化型甲状腺癌诊治指南》，其中明确建议甲状腺结节均应行超声等检查，对于怀疑恶性的结节应行细针穿刺抽吸活检术检查。甲状腺癌的手术方式为甲状腺全（近全）切除术和甲状腺腺叶切除+峡部切除术，同时在有效保护喉返神经和甲状旁腺的前提下应行病灶同侧中央区淋巴结清扫，这些都对甲状腺结节和分化型甲状腺癌的诊治进行了系统的论述。甲状腺结节规范化诊治可以避免诊治失误，提高效果，对于临床工作具有非常重要的意义。

关键词: 甲状腺结节, 规范化, 诊断, 治疗