桥本甲状腺炎伴结节的外科诊治分析(1)
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【摘要】 目的：总结桥本甲状腺炎伴结节的外科诊治体会。方法：分析笔者所在医院于2006-2011年间收治的经手术病理证实的桥本甲状腺炎52例临床资料，探讨桥本甲状腺炎伴结节的外科诊治进展。结果：所有患者进行3个月~5年的随访，无复发。全组无喉返神经损伤，有2例(3.8%)甲状旁腺功能低下。结论：桥本甲状腺炎与甲状腺癌有着密切关系。对怀疑有恶变的甲状腺结节，行细针穿刺细胞学检查或手术探查是提高甲状腺癌检出率的关键。
【关键词】 桥本甲状腺炎； 甲状腺癌； 甲状腺切除术
Study of the Diagnosis and Treatment of Thyroid Nodules Associated with Hashimoto’s Thyroiditis/XU Xiao-hong，TANG Zhi-qin.//Medical Innovation of China，2012，9(28):119-120
【Abstract】 Objective:The purpose of this article is to compare the features of benign and malignant nodules in patients with diffuse Hashimoto’s thyroiditis.Method:Clinical data and approaches to diagnosis and treatment of patients with diffuse Hashimoto’s thyroiditis were retrospectively analyzed.Result:All the patients were followed up in the range of three months to five years.There was no recurrence and no injury of N.laryngeus recurrens.There were 2 cases(3.8%) with hypoparathyroidism.Conclusion:There is a relation between Hashimoto’s thyroiditis and thyroid carcinoma.Patients with diffuse Hashimoto’s thyroiditis and coexisting nodules could be confirmed to be benign or malignant by fine-needle aspiration or surgical pathologic analysis.
【Key words】 Hashimoto’s thyroiditis; Thyroid carcinoma; Thyroidectory
First-author’s address:Affiliated Jiading Branch of Medicine College of Shanghai Jiaotong University Jiading District Central Hospital，Shanghai 201800，China
doi：10.3969/j.issn.1674-4985.2012.28.075
桥本甲状腺炎(Hashimoto’s thyroiditis，HT)又名慢性淋巴细胞性甲状腺炎，是一种较为常见的自身免疫性疾病，患者常表现为双侧甲状腺弥漫性肿大，可伴局部肿块或结节形成。桥本甲状腺炎有可能并发甲状腺恶性肿瘤[1]。文献报道国内外差异较大，国外为0.5%~22.3%[2-4]，国内为0.6%~23.8%[5-6]。笔者所在医院于2006-2011年共收治手术病理证实的桥本甲状腺炎52例，其中并发甲状腺癌6例，甲状腺恶性淋巴瘤1例，现报告如下。
1 资料与方法
1.1 一般资料 本组52例，其中良性病变45例，恶性病变7例。良性病变组年龄27~82岁，平均年龄(50.64±12.39)岁；女43例，男2例，均以甲状腺肿块就诊，主要通过体检和B超发现。其中单发肿块22例，多发肿块23例。肿块大小0.7~4.0 cm，平均直径(1.54±0.62)cm ......
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