桥本氏甲状腺炎合并结节的临床诊断与治疗  

The Clnical Diagnosis and Treatment analysis of Hashimoto's Thyroiditis which combined thyroid tubercle

作　　者：陈妙苑 罗雪莹[1,3] 陈伟财[1,3] 何劲松[1,3] 

机构地区：[1]广州医科大学,广东广州510570 [2]深圳市罗湖区人民医院,广东深圳518001 [3]深圳市第二人民医院,广东深圳518035

出　　处：《深圳中西医结合杂志》2016年第20期3-5,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：广东省科技计划项目资助课题(2013B021800097);广东省科技计划项目资助课题(2014A020212038);深圳市知识创新计划基础研究项目资助课题(JCYJ20150330102720122);广东省自然科学基金资助课题(2016A030313029)

摘　　要：目的:探索桥本氏甲状腺炎合并甲状腺结节的诊断方法,为进一步规范桥本氏甲状腺炎合并甲状腺结节的临床诊断及治疗方法提供理论依据。方法:使用回顾性分析深圳罗湖区人民医院在2010年9月至2015年9月行甲状腺结节手术患者378例的临床资料。据病理诊断结果,分为观察组和对照组。术前甲状腺微粒体抗体和甲状腺球蛋白抗体检测结果经统计学分析,同时结合抗体水平评价其对辅助诊断桥本氏甲状腺炎合并甲状腺结节的临床意义。观察组按照其病理诊断类型,分为桥本氏甲状腺炎合并结节性甲状腺肿组、桥本氏甲状腺炎合并甲状腺腺瘤组、桥本氏甲状腺炎合并甲状腺癌组3组,对发病年龄、术前TSH水平以及甲状腺结节钙化率和术前甲状腺自身抗体阳性率进行分析是否存在差异。结果:出现了桥本氏甲状腺炎合并结节性甲状腺结节患者60例、桥本氏甲状腺炎合并甲状腺腺瘤患者13例、桥本氏甲状腺炎合并甲状腺癌患者27例。结论:桥本氏甲状腺炎合并甲状腺结节患者在临床发病的过程中,其血清学甲状腺微粒体抗体以及甲状腺球蛋白抗体要明显高于单纯性甲状腺结节患者,因此血清学甲状腺微粒体抗体以及甲状腺球蛋白抗体可以作为对桥本氏甲状腺炎合并甲状腺结节的辅助诊断方法。桥本氏甲状腺炎合并甲状腺结节患者实施治疗过程中,术前TSH检查水平对确诊桥本氏甲状腺炎合并甲状腺癌有着较高的指导意义。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 shed a light on the clinical diagnosis and medication of Hashimoto＇s thyroiditis complicated with goiter and Hashimoto＇s thyroiditis complicated with thyroid nodules.Method In a retrospective study,378 cases were in row from Shenzhen Luo Hu People＇s Hospital during September 2010 to September 2015.Patients were divided into the observation group and control group according to the pathological diagnosis.The preoperative thyroid microsomal antibody and thyroid globulin antibody results were analyzed.The diagnosis of Hashimoto＇s thyroiditis with thyroid nodules was evaluated by combing with the antibody level.The patients in the observation group were classified as Hashimoto＇s thyroiditis complicated with goiter,Hashimoto＇s thyroiditis complicated with thyrophyma and Hashimoto＇s thyroiditis complicated with Thyroid Carcinoma according to the histological diagnosis.Meanwhile,the clinic features such as onset age,pre-operation TSH level,anti-thyroid antibodies and nodular calcification were evaluated.Results In this study,60 cases from the observation group were confirmed as Hashimoto＇s thyroiditis complicated with goiter,while 13 cases were diagnosed as Hashimoto＇s thyroiditis complicated with thyrophyma,and 27 cases were considered as Hashimoto＇s thyroiditis complicated with Thyroid Carcinoma.Conclusion We observed that the thyroid microsomal antibody and thyroid globulin antibody in the Hashimoto＇s thyroiditis complicated with goiter cases were dramatically higher than that in simple thyroid nodule cases in the progress and they might be potential diagnostic indicators.During the treatment against Hashimoto＇s thyroiditis complicated with goiter,pre-operation TSH level provide a guide for the diagnoses of Hashimoto＇s thyroiditis complicated with Thyroid Carcinoma.Once a patient who was pre-diagnose as Hashimoto＇s thyroiditis complicated with Thyroid Carcinoma,thyroid microsomal antibody and thyroid globulin antibody titer,TSH level,ultrasound guided fine needle suction cytolo

关 键 词：桥本氏甲状腺炎 甲状腺结节 临床诊断 

分 类 号：R581[医药卫生—内分泌]