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目的　探讨并发甲状腺结节的桥本病外科治疗的临床效果。方法　总结 1985年 1月至 1999年 6月外科手术治疗并经病理证实的桥本病 10 0例 ,分析手术方式和范围与术后疗效和甲状腺机能减退 (下称甲减 )之间的关系。结果　全组病例均并发甲状腺结节 ,其中甲状腺癌 (下称甲癌 ) 10例 ,甲状腺瘤 (下称甲瘤 ) 8例 ,甲状腺机能亢进 (下称甲亢 ) 14例 ,结节性甲状腺肿 18例 ,其余为桥本病淋巴瘤样肿结节。根据不同情况均采取了不同范围的甲状腺切除术 ,其中一侧或双侧甲状腺全切除和次全切除术所占比例达 71%。全组病例服用甲状腺素随访 2年 ,无甲减发生。 6 7%的病例可停药。术后随访 5年 ,除并发甲癌者继续服药外 ,其余均停药 ,只有 2例出现甲减。结论　并发甲状腺结节的桥本病应予以手术治疗 ,手术方式应根据具体情况而定 ,术后 5年甲减发生率低

Surgical treatment of Hashimoto disease complicated with thyroid tubercles

Objective To investigate the clinical effect of surgical treatment on Hashimoto disease(HD)complicated with thyroid tubercles.Methods 100 cases with HD treated by surgical operations and confirmed by pathological examinations from Jan.1985 to Jun.1999 were reported,and the relation between opetative style,extent and postoperative effect,hypothyroidism were analysed.Results All cases were complicated with thyroid tubercles,among which 10 were thyroid cancer,8 were thyroid tumor,14 were hyperthyroidism,18 were nodular goiter and the others were lymphomatosa tubercles of HD.According to the different circumstances,the various styles of thyroidectomy were performed,of which total and subtotal thyroidectomies of one or bilateral lobes were performed on 71% of all cases.All cases were given thyroxine and followed up for 2 years and no one presented hypothyroidism.Thyroxine was withdrawn in 67% of all cases.In 5 years' follow-up,all cases withdrew thyroxine except the patients with thyroid cancer.Only 2 cases presented hypothyroidism.Conclusion HD complicated with thyroid tubercles should be treated surgically.The operative styles should be selected according to the disease conditions.The occurrence rate of hypothyroidism was low within 5 years after operation.