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目的探讨结节性甲状腺肿伴结节内出血与亚急性甲状腺炎的临床鉴别。方法以3例结节性甲状腺肿伴结节内出血病例的诊治资料,回顾性分析其临床表现、诊断及治疗,并讨论其与亚急性甲状腺炎的临床鉴别要点。结果 3例患者在结节内出血急性期有突发甲状腺肿痛、发热、血沉升高、甲状腺摄131I降低以及一过性甲状腺功能异常等类似亚急性甲状腺炎的临床表现,通过甲状腺B超和甲状腺细针穿刺活检可确诊为结节性甲状腺肿伴结节内出血。其中2例患者行手术治疗,另1例暂未行手术治疗,患者经随访甲状腺功能均恢复正常。结论结节性甲状腺肿伴结节内出血急性期易误诊为亚急性甲状腺炎,两者的鉴别诊断可有效避免糖皮质激素的误用。
Objective To investigate the clinical identification of nodular goiter with intra-nodular hemorrhage and subacute thyroiditis. Methods The clinical data, diagnosis and treatment of 3 cases of nodular goiter with intra-nodular hemorrhage were retrospectively analyzed. The main points of clinical identification of subacute thyroiditis were discussed. Results Acute thyroiditis, fever, elevated erythrocyte sedimentation rate, decreased thyroid 131I, and transient hypothyroidism were observed in 3 patients during acute nodular hemorrhage. The clinical manifestations of subacute thyroiditis such as thyroid gland Fine needle aspiration biopsy can be diagnosed as nodular goiter with intra-nodular hemorrhage. Among them, 2 patients underwent surgical treatment, while the other 1 patient had no surgical treatment at the moment. The thyroid function returned to normal after follow-up. Conclusion Nodular goiter with nodular hemorrhage in the acute phase is often misdiagnosed as subacute thyroiditis, the differential diagnosis of the two can effectively avoid the misuse of glucocorticoid.