摘要
目的 探讨桥本病 (HD)并甲状腺腺瘤 (TA )的诊断与治疗。方法 对 5 0例HD并TA的临床资料进行回顾性分析。结果 5 0例中 ,术前诊断为HD并TA者仅 8例 ,误诊、漏诊达 84.0 %。术中快速切片确诊率为 81.4% (3 5 / 43 )。术后病理切片确诊 5 0例。根据患者具体情况采取不同范围的甲状腺切除术。术后 2 7例口服小剂量甲状腺素 ,2例口服小剂量强的松。所有患者均获随防 ,随访时间为 3个月～ 1年 ,未发生甲状腺机能减退者。结论 全面的血清免疫学检查、B超、细针抽吸细胞学检查有助于诊断。HD并TA应予以手术治疗。术中快速切片对确诊有重要价值。其手术方式、切除范围及术后药物治疗应个体化 ,尽可能避免术后甲状腺机能减退的发生。
Objective To investigate the diagnosis and treatment of hashimoto′s disease(HD) complicated with thyroid adenomas(TA).Methods Clinical data of 50 cases of HD complicated with TA were analysed retrospectively. Results 8 patients were diagnosed before operation ,misdiagnosis rate was 84.0%.Intra operation frozen section diagnosis rate was 81.4% (35/43).All patients were diagnosed as HD complicated with TA by pathology after operation.Various extension thyroidectomies were performed according to the patients conditions. After operation,27 cases were given small dosage of thyroxine and 2 cases were given small dosage of prednisone. All the 50 patients were followed up for 3 months to 1 year, none presented hypothyroidism.Conclusions Complete serum immunologic examinations,ultrasonography and fine needle aspiration biopsy are helpful for the diagnosis of HD with TA. HD with TA should be treated surgically,and the intraoperation frozen section for the diagnosis is important.The operation procedures,extension of excision and medication after operation should be individulization to avoid the occurrence of postoperative hypothyroidism as possible.
出处
《中国普通外科杂志》
CAS
CSCD
2003年第10期730-732,共3页
China Journal of General Surgery
