|
桥本病的临床诊断和治疗 |
| |
施俊义 方国恩 盛援
【摘 要】 目的 总结分析桥本病临床诊断和治疗经验及影响诊断的相关因素。方法 回顾1993～1999年收治的桥本病42例，对其发病、临床表现、诊断以及治疗进行分析。结果 42例中19例临床作出桥本病诊断，27例接受手术治疗，术后诊断均为桥本病，其中并发甲状腺癌3例(7.14%)，甲状腺机能亢进4例(9.52%)，甲状腺机能减退8例(19.05%)。误诊率为54.67%，甲状腺癌漏诊率为66.67%。结论 桥本病女性多于男性，中年好发，可伴发甲状腺机能异常和甲状腺恶性肿瘤；掌握其临床特点，结合甲状腺自身免疫球蛋白的检测，可以降低术前误诊率，有经验的细针穿刺细胞学检查能够帮助提高诊断率；恰当的治疗方案和常规术中冰冻切片病理检查，能使病人得到更合理有效的治疗。
【关键词】 桥本病 自身免疫 甲状腺炎
Clinical diagnosis and treatment of Hashimoto disease
Shi Junyi,Fang Guoen,Sheng Yuan
(General Surgery Department,Changhai Hospital,the Second Military Medical University of PLA,Shanghai 200433)
【Abstract】 Objective Clinical experience of treating Hashimoto disease and its related factors were discussed.Methods 42 cases of Hashimoto disease were reviewed from 1993 to 1999.Their clinical behaviors,symptoms,diagnosis and treatment were analyzed.Results 19 of 42 cases of Hashimoto disease were diagnosed clinically before operations.27 cases underwent surgical procedures.Pathological diagnosis revealed all the cases were Hashimoto disease,of which 3 accompanied by(7.14%)thyroid cancer,4 cases(9.52%)by hyperthyroidism and 8 cases(19.5%)by hypothyroidism.Conclusion Hashimoto disease is not infrequency.There are more female cases than male ones.It more likely occurs in middle ages,going with hyper or hypothyroidism and thyroid malignant tumor.It will improve the preoperative diagnosis accuracy to study the clinical features combined with detemination of serum autoimmune antibodies.FNAB can be helpful.Proper clinical projects will make the treatments more effective.
【Key words】 Hashimoto disease Autoimmune Thyroiditis
桥本病是一种非特异性甲状腺炎症，近年来发病率有上升趋势，因而引起了广泛的重视。目前，关于桥本病的处理尚存在不少问题，一是误诊率高，可达75%～100%，二是治疗不规范。本院1993～1999年共收治桥本病42例，现就临床诊治问题总结讨论如下。
1 临床资料与方法
1.1 临床资料
42例中，男5例，女37例，男女比例为1∶7.4。年龄13～71岁，中位数39岁。主诉为颈部肿块27例，颈部肿大19例，其中肿大并肿块4例，疼痛3例，压迫感2例，心悸3例，下肢水肿2例。检查甲状腺弥漫性Ⅱ°肿大12例，Ⅲ°肿大7例；甲状腺肿块27例，单侧肿[1] [2] 下一页
上一个医学论文： 局灶性淋巴细胞性甲状腺炎手术治疗及其滤泡细胞凋亡与增殖状况的免疫组化分析
下一个医学论文： 亚急性甲状腺炎药物治疗效果及形态与功能的观察
|
|
|
|
|
|
|
您现在的位置： 绿色健康网 >> 医学论文 >> 外科论文 >> 正文