甲状腺结核的临床研究(附16例临床分析)

目的：提高甲状腺结核的诊治水平。材料与方法：回顾性研究了我院38年来21136例甲状腺手术病例中的16例甲状腺结核的病例。女性12例,男性4例,1980年以前7例（7/16）,平均年龄32.4岁,2000年后发病6例（6/16）,平均年龄45.5岁;7例有甲状腺外结核;2例在术前诊断为该病并行抗痨治疗。术式：甲状腺侧叶切除8例,双侧叶大部切除2例,甲状腺全切4例,甲状腺切除并淋巴摘除术2例。结果：本组病理分型：肉芽肿型8例,干酪型7例,弥漫型1例。随访3年所有病例痊愈。结论：甲状腺结核罕见,近10年来发病年龄逐渐增大,但在甲状腺疾病中的构成比未变,其临床上少有特异性的表现,在术前很难诊断,但是通过对其临床表现的研究和诊断方法的综合应用,一定程度上能够提高诊断的准确性。手术结合抗痨治疗是甲状腺结核最有效的治疗手段。

Clinical Study on Thyroid Tuberculosis:Reports of 16 Cases

Objective:The purpose is to improve the lever of diagnose and therapy in dealing with thyroid tuberculosis.Material and Methods:Sixteen cases of thyroid tuberculosis in 21136 cases of thyroid disease with operation were retrospectiody studied within a 38-year period.There were 12 females and four males,7 cases were diagnosised before the year of 1980,and the mean age was 32.4 years;6 cases were diagnosised after The year of 2000 year,and the mean age was 45.5 years.Only 2 cases were diagnosed with thyroid tuberculosis before operation and were under auti-tuberculosis theyapy.Operation method:8 patients underwent lobo-isthmectomy,2 patients underwent bilateral near-total thyroidectomy,4 patients underwent total thyroidenosisctomy and 2 patients underwent total thyroidectomy combined dissection of lymph node of neck.Results:pathology of these cases:8 cases were granulomatous type;7 cases were caseation type;1 case was diffuse type.The outcome was favorable in all of the cases from follow up.Conclusion:Thyroid tuberculosis was rare,Though the age of patientes were increased in the recent 10 years,the constituent ratio of this disease was still the same.there was no specific symptoms in thyroid tuberculosis,it was difficult to diagnos before operation,but through the study of symptoms and comprehensive applications of diagnostic means,accuncy of the diagnosis could be improved.Surgrcal therapy combined with medical treatment were most useful method to that thyroid tuberculosis.