结节性甲状腺肿合并慢性淋巴细胞性甲状腺炎22例临床分析

Clinical Analysis of Nodular Goiter Accompanied by Chronic Lymphocytic Thyroiditis

目的 总结结节性甲状腺肿 (结甲 )合并慢性淋巴细胞性甲状腺炎 (CLT)的诊治经验。方法 对 1989— 2 0 0 1年手术治疗的 2 2例结甲合并CLT的临床资料进行回顾性分析。结果 全部病例均经病理证实 ,术前诊断率为 4 0 .9%。根据不同术前诊断采取了不同手术方法。术后甲状腺功能减退 (甲减 )发生率为 15 .0 % ,甲状腺结节复发率为 9.1%。结论 应重视结甲合并CLT的诊断 ,甲状腺细针穿刺及术中冰冻切片有助于明确诊断。手术治疗是可行的 ,正确采取手术方法和切除范围能够有效防止术后甲减和结节复发。

Objective Clinical experience in diagnosis and treatment of nodular goiter accompanied by chronic lymphocytic thyroiditis were discussed.Methods 22 cases of modular goitre accompanied by chronic lymphocytic thyroiditis were reviewed from 1989 to 2001.Results All cases were surgically treated and diagnosed by pathology.Preoperative diagnostic rate were 40.9%.According to different preoperative diagnosis.the various styles of thyrodectomy were performed.Postoperative hypothyroidism rate was 15.0%, and nodule recurrence rate was 9.1%.Conclusion Both fine needle aspiration biopsy and frozen stice are both useful in the diagnosis of nodular goiter accompanied by chronic lymphocytic thyroiditis.Accurate operative styles and resection range could prevent postoperative hypothyroidism and nodule recurrence effectively.