| Purpose:Hashimoto's thyroiditis, also known as chronic lymphocyticthyroiditis is an autoimmune disease is the most common form of thyroiditis,goiter hypothyroidism, the most important reason.The insidious onset of thedisease symptoms are not typical, and easily merge a variety of other thyroiddiseases, it is easy to misdiagnosis, wrong treatment and underwent surgicaltreatment.Inappropriate surgical resection can easily lead to thyroiddysfunction occurred in advance, so preoperative diagnosis is particularlyimportant for Hashimoto's thyroiditis.In this paper, the past clinical cases, andsummarize the diagnosis and treatment of Hashimoto's thyroiditis experience.Methods: Retrospective analysis of our hospital in2002January1,2012January1, surgical treatment and pathological diagnosis of HT309clinicalcases of gender, age, symptoms, medical history, associated symptoms,laboratory examination, imaging, diagnosis, pathology results and otheraspects of the same and different points. And a random sample of the sametime of surgery but the pathological diagnosis of200cases of clinical data inthe blood of the other thyroid diseases, thyroid stimulating hormone level,thyroglobulin antibody and thyroid microsomal antibody over peroxidaseantibody positive rate and TG-Ab and the TM-Ab titer to do a controlledstudy.Results: The HT group, women accounted for94.04%, males accountedfor5.96%male to female ratio of approximately16:1. The average age of17-77years old, average age46.93±11.80years, a history of one day to40years ranging from an average of3.89±7.13years. HT group all the discoveryof the thyroid or neck growth crude admission, thyroid palpation60.84%diffuse thyroid Ⅰ-III degree of swelling, with or without nodules, and only38.83%and nodules. Thyroid tissue and nodular texture of a hard or tough.Can accompany hyperthyroidism (nine cases), hypothyroidism (5cases), tracheal and esophageal nerve compression (73cases,42cases,8cases), pain(8cases), a variety of symptoms. Preoperative majority of thyroid ultrasound,thyroid function, thyroid autoantibodies and other checks. The comparativeanalysis of two sets of data, TSH values of the HT group,18.31±9.56μIU/mlsignificantly higher than3.12±1.08μIU/ml (P <0.05); HT group TG-Ab andthe TM-Ab, TPO-Ab in positive rate of47.20%,52.94%,89.53%wassignificantly higher than18.75%,16.67%,52.73%(P <0.05); HT groupTG-Ab and the TM-Ab titer of44.04±11.35%,23.75±9.17%wassignificantly higher than the13.74±4.12%,6.75±2.96%(P <0.05). HTgroup patients paraffin pathology results of218cases of Hashimoto'sthyroiditis (purely for Hashimoto's thyroiditis209cases; fiber type4cases ofHashimoto's thyroiditis; with Hashimoto's thyroiditis,2cases of papillaryhyperplasia; Hashimoto's thyroiditis with adenomatous hyperplasia of thethree cases), the merger of35cases of thyroid cancer (papillary carcinoma,30cases; four cases of follicular carcinoma; medullary carcinoma withneuroendocrine tumor in1case), the merger of eight cases of toxic goiter,merge node a17cases merger of30cases of thyroid adenoma, with wood-likegoiter one cases; HT HT group, the preoperative diagnosis probability of23.30%; number of patients with postoperative elevated TSH, the proportionof73.83%compared with patients with elevated preoperative TSH38.24%ofthe share number was significantly higher (P <0.05).Conclusion: The incidence of HT in recent years significantly increased,mostly women, the good age of30-50years old; the probability of HT patientswith hypothyroidism than other thyroid disease; TPO-AB positive rate andhigh-titer TGAB TMAB on thediagnosis; HT easy to merge a variety ofthyroid diseases, in particular, should be noted that a high proportion ofthyroid cancer; HT preoperative diagnosis rate is very low, the need for morespecific diagnostic methods, such as thyroid fine needle aspiration cytology(ofFNAC); indications for surgery patients should be treated surgically, but toselect the appropriate surgical approach; the risk of postoperativehypothyroidism was significantly higher than before surgery. |
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