桥本病并发甲状腺恶性肿瘤18例的诊断与治疗  

Diagnosis and treatment of thyroid malignant tumors concomitant with Hashimoto′s disease: report of 18 cases

作　　者：徐少明[1] 王平[1] 虞志刚[1] 

机构地区：[1]浙江大学医学院附属第二医院外科,杭州310009

出　　处：《中华普通外科杂志》2001年第7期427-428,共2页Chinese Journal of General Surgery

摘　　要：目的　总结桥本病 (HD)并发甲状腺恶性肿瘤 (TMT)的诊治经验。方法　回顾 1976年 1月至 1999年 4月期间 15 0例HD中同时并存TMT 18例的发病机理和诊治经验。结果　HD与甲状腺癌 (TC)并发率为 10 % (15 /15 0 ) ,TC术前确诊率 47% (7/15 ) ;HD与甲状腺恶性淋巴瘤 (TML)并发率为 2 % (3/15 0 ) ,术前均误诊。总并发率为 12 % ,均经手术治疗。TC 15例获访 ,无复发 ,效果满意。TML 3例 2年内均死亡 ,预后差。结论　HD与TC、TML并发率较高 ,术前应常规测血TGA、TMA、细针穿刺、术中作冰冻切片 ,利于术前、术中确诊 ,并选择正确的手术方法 ,使治疗更合理有效。Objective To explore the diagnosis and treatment of thyroid malignant tumor (TMT) arising on basis of Hashimoto′s disease (HD).Methods 150 pathology proved HD patients admitted between 1976 and 1999 were retrospectively analyzed for the incidence of TMT.Results 15 HD patients were found suffering from thyroid carcinoma with a concurrent rate of 10%, and 3 with thyroid malignant lymphoma (TML) (2%). All postoperative TMT patients were followed up for an average period of 6 years, 15 TC patients were all alive without recurrence, and all TML patients died within 2 years.[WT5”HZ] Conclusion Surgical treatment of HD patient associated with TMT is indicated. The key to diagnosis and rational treatment are a detailed understanding its clinical feature, routine examination of serum antibodies and FNAC or frozen section in operation.

关 键 词：自身免疫性甲状腺炎 甲状腺肿瘤 淋巴瘤 并发症 桥本病 诊断 治疗 

分 类 号：R653[医药卫生—外科学]