桥本氏甲状腺炎的诊断和外科治疗  

The Clinical Diagnosis and Surgical Treatment of Hashimoto's Thyroiditis

作　　者：张平[1] 张大林[1] 王志宏[1] 贺亮[1] 董文武[1] 张浩[1] 

机构地区：[1]中国医科大学附属第一医院普通外科教研室,甲状腺外科,沈阳110001

出　　处：《中国医科大学学报》2013年第12期1102-1104,共3页Journal of China Medical University

基　　金：高等学校博士点专项科研基金(20122104110006);辽宁省科学技术计划(2012225087);辽宁省“百千万人才工程”资助项目(2010921070);辽宁省教育厅创新团队资助项目(LT2010102)

摘　　要：目的探讨桥本氏甲状腺炎的诊断、手术适应证及手术方式。方法回顾性分析1995年1月至2012年1月我院外科手术治疗的455例桥本氏甲状腺炎患者的临床资料。结果术后病理结果:单纯桥本氏甲状腺炎151例,桥本氏甲状腺炎合并毒性甲状腺肿21例,合并结节性甲状腺肿160例,合并甲状腺腺瘤45例,合并甲状腺癌78例。结论桥本氏甲状腺炎常合并其他甲状腺疾病。彩超和细针穿刺细胞学检查及甲状腺免疫功能检测有助于术前确定诊断。对疑有恶变或产生压迫症状者应积极手术。手术应遵循个体化原则,依具体情况选择合适的手术方式,尽量保留正常的甲状腺组织。Objective To investigate the clinical diagnosis, operative indication, and surgical treatment of Hashimoto＇ s thyroiditis. Methods The clinical data from 455 cases of Hashimoto ＇ s thyroiditis, whom underwent operation between January 1995 and Januaiy 2012, were reviewed and ana- lyzed retrospectively. Results Postoperative pathology of all eases confrrmed the diagnosis of Hashimoto ＇ s thyroiditis. There were 151 eases of sim- ple Hashirooto＇ s thyroiditis, and the amount of eases concomitant with hypelthyroidism, nodular goiter, adenoma, and thyroid carcinoma were 21, 160,45 and 78 respectively. Conclusion Hashimoto＇ s thyroiditis is often complicated with other thyroid diseases. Sonography, fine needle aspira- tion cytology and thyroid hormone parameters may be helpful for preoperative diagnosis. Surgical treatment should follow tile individualized principle. Operations should be actively performed on these eases which are likely to malignant or easily to induce compressive symptoms. Optimal operative procedures are chosen according to the individual condition. Normal thyroid tissue should be retained in situ as much as possible.

关 键 词：桥本氏甲状腺炎 外科治疗 甲状腺癌 

分 类 号：R653[医药卫生—外科学]