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目的探讨桥本甲状腺炎(Hash imoto thyroid itis,HT)和亚急性甲状腺炎(subacute thyroid itis,SAT)的诊断和治疗。方法对我院于2000~2005年外科治疗的100例病理诊断桥本甲状腺炎和亚急性甲状腺炎进行回顾性分析,其中桥本甲状腺炎71例,亚急性甲状腺炎29例。结果71例HT经手术治疗和补充甲状腺素治疗后患者恢复良好,无并发症发生。29例SAT经手术证实诊断后应用肠溶阿司匹林和甲状腺素治疗,效果确切。结论(1)重视亚急性甲状腺炎的临床表现,避免误诊造成的不必要的手术治疗。(2)肠溶阿司匹林结合甲状腺素药物治疗亚急性甲状腺炎可取得良好结果。(3)对于内科治疗效果欠佳的桥本甲炎,可考虑外科手术干预,同时可发现和治疗并存疾病。(4)对部分桥本甲状腺炎施行甲状腺近全切除术,术后辅助甲状腺素替代治疗是可行的,可达到满意疗效。
Objective To investigate the diagnosis and treatment of Hashimoto thyroid itis (HT) and subacute thyroid itis (SAT). Methods A retrospective analysis of 100 pathological diagnosis Hashimoto’s thyroiditis and subacute thyroiditis in our hospital from 2000 to 2005 was conducted. Among them, 71 were Hashimoto’s thyroiditis and 29 were subacute thyroiditis. Results 71 cases of HT after surgery and supplementation of thyroxine patients recovered well without complications. 29 cases of SAT confirmed by surgery after the application of enteric-coated aspirin and thyroxine treatment, the exact effect. Conclusions (1) Pay attention to the clinical manifestations of subacute thyroiditis and avoid unnecessary surgical treatment caused by misdiagnosis. (2) enteric-coated aspirin in combination with thyroxine treatment of subacute thyroiditis can achieve good results. (3) For Hashimoto’s thyroiditis, which is ineffective in medical treatment, surgical intervention may be considered, and concurrent diseases may be found and treated. (4) Partial Hashimoto’s thyroiditis undergone thyroidectomy, postoperative adjuvant thyroxine replacement therapy is feasible, can achieve satisfactory results.