桥本病的诊断与外科治疗

Diagnosis and surgical treatment of Hashimoto disease.

目的 总结桥本病的外科诊治经验。方法 回顾分析 1995年 1月至 1999年 2月收治的 5 3例桥本病发病情况、诊断和治疗。结果 5 3例均经手术治疗。与病理检查对照 ,术前误诊率明显下降。手术方法选择正确率达到 6 9 8% ,术后甲状腺功能减低发生率为 14 3 %。并发甲状腺癌 8例 (占 15 % ) ,恶性淋巴瘤 1例 (占1 9% )。结论 桥本病是常见病 ;正确掌握其临床特征、常规测血清抗体 (TGA、TMA)、有选择地作FNAC检查、注意与其它甲状腺疾病鉴别可降低术前误诊率 ;重视并发恶性肿瘤 ;术中常规作冰冻切片检查 ,利于选择正确的手术方法 ,使治疗更合理。

Objective To further summarize our experience in diagnosis and surgical treatment of Hashimoto's disease.Methods From Jan.1995 to Feb.1999,53 cases of HD were evaluated in their clinical findings,diagnosis and surgical treatment.Results HD were surgically treated in all 53 cases and diagnosed by pathology,preoperative corrective diagnosis were 58\^5%(31/53),correctly operated patients were 69\^8%(37/53),coexistance of thyroid carcinoma were 15%(8/53),postoperative hypothyroidism were 14\^3%(7/49).Conclusion The key to correct diagnosis and rational treatment for HD is a detailed understanding of its clinical features,routine examinations of serum antibodies and selective FNAC.