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目的了解社区卫生服务中心门诊就诊患者甲状腺结节检出率及甲状腺功能情况。方法选取2015年3月—2016年6月北京市朝阳区团结湖社区卫生服务中心就诊并接受过甲状腺B超检查的患者488例,检测有无甲状腺结节,其中256例接受甲状腺功能筛查。结果 488例患者中共检出甲状腺结节316例,检出率为64.8%,其中男45例,女271例,男性检出率为68.2%(45/66),女性检出率为64.2%(271/422)。男性与女性甲状腺结节检出率比较,差异无统计学意义(χ~2=0.393,P=0.531)。单发结节146例(46.2%),多发结节170例(53.8%)。不同性别甲状腺结节检出情况比较,差异无统计学意义(χ~2=0.742,P=0.690)。不同年龄组甲状腺结节检出情况比较,差异有统计学意义(χ~2=43.127,P<0.01);其中中年人组、老年人组无结节检出率较年轻人组降低,老年人组无结节检出率较中年人组降低(P<0.01);3组单发结节检出率比较,差异无统计学意义(P>0.05);老年人组多发结节检出率较年轻人组和中年人组升高(P<0.01)。256例接受甲状腺功能检查的患者中,无结节组90例,单发结节组76例,多发结节组90例。3组三碘甲状腺原氨酸(T_3)、甲状腺素(T_4)、游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)水平比较,差异均无统计学意义(P>0.05);3组促甲状腺激素(TSH)水平比较,差异有统计学意义(P<0.05);其中多发结节组TSH水平较无结节组和单发结节组降低(P<0.05)。结论北京市朝阳区团结湖社区卫生服务中心就诊患者甲状腺结节检出率较高,甲状腺结节检出率随着年龄的增大而逐渐增加,尤其是多发结节,在临床工作中应引起注意。
Objective To understand the detection rate of thyroid nodules and thyroid function in outpatients in community health service centers. Methods From March 2015 to June 2016, 488 patients undergoing thyroid ultrasound examination at Tuanjiehu Community Health Service Center, Chaoyang District, Beijing were examined for thyroid nodules, of which 256 were screened for thyroid function. Results A total of 316 thyroid nodules were detected in 488 patients, with a detection rate of 64.8%, including 45 males and 271 females. The detection rate was 68.2% (45/66) in males and 64.2% in females 271/422). There was no significant difference in the detection rate of thyroid nodules between male and female (χ ~ 2 = 0.393, P = 0.531). Single solitary nodules in 146 cases (46.2%), multiple nodules in 170 cases (53.8%). There was no significant difference in the detection of thyroid nodules between different sex (χ ~ 2 = 0.742, P = 0.690). The detection rate of thyroid nodules in different age groups was significantly different (χ ~ 2 = 43.127, P <0.01). The detection rate of nodules in middle-aged and elderly patients was lower than that in younger patients No detectable rate of nodules was found in the middle-aged group (P <0.01); the detection rate of solitary nodules was no significant difference among the three groups (P> 0.05); multiple nodules were detected in the elderly group The rate was higher than the younger group and the middle-aged group (P <0.01). Of the 256 patients who underwent thyroid function tests, 90 had no nodules, 76 had single nodules, and 90 had multiple nodules. There was no significant difference in the levels of T_3, T_4, FT_3 and FT_4 between the three groups (P> 0.05). TSH levels in three groups were significantly different (P <0.05). The TSH level in multiple nodules was lower than that in nodules and single nodules (P <0.05). Conclusion The detection rate of thyroid nodules in Tuanjiehu Community Health Service Center, Chaoyang District, Beijing is higher. The detection rate of thyroid nodules gradually increases with age, especially in multiple nodules, which should be caused in clinical work note.