摘要
目的 探讨慢性淋巴细胞性甲状腺炎 (CLT)的诊断 ,以及CLT合并其它甲状腺疾病的治疗选择。方法 对 1986 -1999年经治的 6 3例CLT的临床资料进行回顾性分析。结果 经非手术诊断2 6例 (其中 11例为经细针穿刺病理学诊断 ) ,诊断率 41.3% ;其余 37例分别误诊为其他甲状腺疾病而行手术治疗 ,其中合并结节性甲状腺肿 2例 ,合并甲亢 6例 ,合并甲状腺瘤 1例 ,合并甲状腺癌 2例 ,合并甲状腺恶性淋巴瘤 1例。 6 3例中 19例予甲状腺素片治疗 ,3例未予治疗 ,4例服甲状腺素片后行手术治疗 ,37例予手术治疗。非手术治疗组均获得较满意的近期效果 ;而手术组中 2 9例 ( 78.4% )获随访 1～ 6年 ,5例发生甲减。结论 全面的血清免疫学检查 ,结合细针穿刺病理检查可望提高CLT的诊断率及非手术诊断率。对可疑病例须谨防遗漏其它合并症。本病以非手术治疗为主 ,对合并其它病变者 ,根据病理类型选择适当的手术或非手术处理方式。
Objective To study the diagnosis of chronic lymphocytic thyroiditis (CLT), and the treatment of CLT companied with other thyroid diseases. Methods Clinical data of 63 cases of CLT were analyzed retrospectively. Results 26 cases were diagnosed by non-operative methods (11 cases by fine needle aspiration biopsy, FNAB). The rest of 37 cases were operated on because of misdiagnosis as other thyroid disease and then comfirmed as CLT by pathology. Of them, 2 were companied with nodular goiter, 6 with Graves' disease, 1 with thyroid adenoma and 2 with carcinoma, respectively. 19 cases were treated by thyroixine, 3 were not treated, 4 treated by operation after thyioxine managment and 37 were treated by operation. Non-operation group had rather satisfied effect in short-term period. 29 cases (78.4%) in operation group were followed up for 1 to 6 years, and 5 cases had hypothyroidism. Conclusions It is necessary to have complete serum immunologic examination and FNAB for suspect patients.They have to be examined carefully in order to avoid omitting complications and incsease the rate of diagnosis.Non-operative treatment is the major therapy of CLT. If CLT is companied with other thyroid disease, operation or non- operation should be adopted according to the pathological type.
出处
《中国普通外科杂志》
CAS
CSCD
2002年第5期279-282,共4页
China Journal of General Surgery
