弥漫性毒性甲状腺肿手术选择的新设想

NEW IDEA ON THE INDICATION OF OPERATION IN GRAVES' DISEASE

作者对47例弥漫性毒性甲状腺肿术后随访3～9年。指出术后甲减与甲状腺残留量、自家抗体滴度和细胞病理改变有密切的关系,为了预防甲减,作者指出有传统手术指征的该病患者应常规作MCA、TGA检测,针吸细胞学检查。当针吸镜检有明显上皮细胞多形性和淋巴细胞浸润,抗体滴度又为高滴度时不宜手术。

Forty-seven patients with Graves' disease and subtotal thyroidectomy have been followed 3-9 years in thyroid functions. The results showed that there was a significant correlation between postoperative hypothyroidism and the titers of autoantibodies, amount of residual thyroid and cytopathology. The authors suggest that hyperthyroidism patients with conventional indication of operation should have assay of MCA and TGA and fine needle aspiration biopsy of thyroid. If the biopsy shows epithelial polymorphism and lymphoid cell infiltration and the titers of the autoantibodies are high, drug therapy should be considered instead of thyroidectiomy.