慢性淋巴细胞性甲状腺炎外科诊治分析  

Diagnosis and Surgical Treatment of Chronic Lymphocytic Thyroiditis

作　　者：陆贝[1] 蔡阳[1] 封光华[1] 朱玮[1] 

机构地区：[1]浙江省杭州市第一人民医院普外科,310006

出　　处：《医学研究杂志》2007年第7期47-49,共3页Journal of Medical Research

摘　　要：目的探讨桥本甲状腺炎的诊断与外科治疗。方法回顾性分析1995～2005年住院手术治疗的36例桥本甲状腺炎患者的临床和病理资料。结果36例患者均经病理证实为慢性淋巴细胞性甲状腺炎,其中合并结节性甲状腺肿6例,甲状腺腺瘤5例,甲状腺癌3例;术前表现为甲状腺肿块29例、甲状腺重度肿大5例、甲状腺疼痛2例;良性23例行一侧或双侧腺叶大部/次全切除,或合并峡部切除,恶性的3例行一侧全切加对侧次全切加峡部切除,并行同侧颈部淋巴结清扫。结论对桥本甲状腺炎怀疑恶性可能、甲状腺肿大产生压迫症状或合并疼痛、药物治疗无效的病人应积极手术治疗;术中根据冷冻病理切片结果决定手术方式;术后长期给予甲状腺素替代治疗能取得良好的效果。Objective To discuss the diagnosis and surgical management of Hashimoto＇ s disease. Methods Clinical and pathological datas of 36 cases with Hashimoto＇ s disease from 1995 to 2006 were studied retrospectively. Results 36 cases were all confirmed to be chronic lymphocytic thyroiditis by pathological examination, 6 cases, 5 cases and 3 cases were apartly accompanied by nodular goiter, thy- roid adenoma and thyroid cancer among them; The clinical manifestations before operation included thyroid nodules in 29 cases, thyroid seriously enlarged in 5 cases, thyroid pain in 2 cases ; Great partial/subtotal thyroidectomy in one or both part were taken in 23 benign ca- ses, or together with isthmus excision, 3 malignant case received total and subtoal thyroidectomy in either part with isthmus and homolatera neck dissection. Conclusions Surgery is actively to be advised when carcinoma under suspicion, thyroid enlarged with pressure symp- toms or pain, medication is ineffective. The mode of operation should be selected according to intraoperative frozen section. A long - term substitute medication of thyroxin can help to obtain a good prognosis after operation.

关 键 词：桥本病 甲状腺炎 甲状腺肿瘤 甲状腺切除术 

分 类 号：R581.4[医药卫生—内分泌]