余萍萍 白瑞雪 刘华

[摘要]目的 探讨重庆市某大型综合医院45岁以下职工甲状腺异常情况。方法 回顾性分析2017年于重庆市某大型综合医院进行健康体检的45岁以下青年职工的甲状腺超声检查结果。结果 受检者总计1661例，其中男356例，女1305例。检出甲状腺异常658例，阳性检出率为39.61%，其中男102例，女556例，阳性检出率分别为28.65%、42.61%，女性受检者的甲状腺异常阳性检出率明显高于男性，差异有统计学意义（χ2=22.77，P<0.01）。甲状腺异常包括甲状腺结节226例（其中21例性质待定）、甲状腺回声不均质199例、甲状腺囊肿132例、甲状腺胶质囊肿81例、甲状腺大小异常10例和甲状腺腺瘤10例。女性受检者的甲状腺结节和甲状腺回声不均检出率均显著高于男性，差异有统计学意义（χ2=6.34，P<0.05；χ2=11.79，P<0.05）。不同性别受检者的甲状腺囊肿、甲状腺胶质囊肿以及甲状腺大小异常检出率比较，差异均无统计学意义（P>0.05）。随访发现甲状腺癌2例，占甲状腺检查异常率的0.30%，占总受检人数的0.12%。结论 甲状腺彩超应作为健康体检的常规检查项目，其对甲状腺疾病的早发现、早诊断、早治疗具有重大的意义。

[关键词]甲状腺；超声检查；健康体检

[中图分类号] R443 [文献标识码] A [文章编号] 1674-4721（2018）7（a）-0167-03

[Abstract]Objective To investigate the abnormalities of thyroid in workers under 45 in a large general hospital in Chongqing.Methods The results of thyroid ultrasonography of young workers under 45 who underwent the health examination in a large general hospital in Chongqing City in 2017 were retrospectively analyzed.Results A total of 1661 cases were examined，including 356 males and 1305 females.A total of 658 cases were detected with thyroid abnormalities，whose positive detection rate was 39.61%，including 102 males and 556 females，the positive detection rates 28.65% and 42.61% respectively.The thyroid abnormality positive detection rate of female subjects was significantly higher than that of males，and the difference was statistically significant （χ2=22.77，P<0.01）.Thyroid abnormalities included 226 cases of thyroid nodules （21 of which were to be determined），199 cases of thyroid echo inhomogeneity，132 cases of thyroid cysts，81 cases of thyroid colloid cysts，10 cases of abnormalities of thyroid gland size，and 10 cases of thyroid adenomas.The detection rate of thyroid nodules and thyroid echo inhomogeneity of females subjects were significantly higher than those of males，and the differences were statistically significant （χ2=6.34，P<0.05；χ2=11.79，P<0.05）.The comparsion of detection rate of thyroid cysts，thyroid colloid cysts and thyroid size showed no significant differences （P>0.05）.Two cases of thyroid cancer were found in clinical follow-up，accounting for 0.30% of the thyroid abnormality rate and 0.12% of the examined population.Conclusion Thyroid color doppler ultrasound should be used as a routine check-up program for health examinations，which is of great significance for early detection，early diagnosis，and early treatment of thyroid diseases.

[Key words]Thyroid；Ultrasonography；Health examination

甲狀腺是人体内分泌系统中最大的内分泌腺，它受到神经刺激后分泌甲状腺激素，作用于人体相应器官而发挥生理效应。近30年来，甲状腺癌的发病率成为增长最快的癌症之一，男、女性甲状腺癌呈快速上升趋势[1-3]，其发病与多种因素有关，如甲状腺良性疾病、家族遗传史、情绪压力、辐射暴露和环境污染等都是甲状腺癌的危险因素[2-4]。面对逐年增加的甲状腺疾病，应该积极寻找患病的危险因素和加强甲状腺疾病普查工作，而超声波检查对甲状腺疾病具有较高的诊断价值，甲状腺彩超检查作为常规检查项目，对筛查、诊断甲状腺疾病具有广泛的临床意义。本研究选取2017年重庆市某大型综合医院进行甲状腺彩超检查的45岁以下青年职工作为研究对象，进行甲状腺彩超检查及分析，旨在使青年医务人员了解甲状腺疾病的发病情况及恶性肿瘤占甲状腺疾病的比例，为预防和干预甲状腺疾病提供依据，现报道如下。……