Botelho L de S, Rosenthal D, Machado Filho A, Figueiredo J G
Inst. Carlos Chagas Filho, Univ. Fed. do Rio de Janeiro.
Rev Assoc Med Bras (1992). 1992 Apr-Jun;38(2):85-9.
The postoperative goiter recurrence and hypophysial-thyroid function in 39 patients who underwent partial thyroidectomy for nontoxic multinodular goiter, during the 1970-1983 period, was evaluated, seeking relations among thyroid function, extension of surgery and goiter recurrence. The incidence of recurrent goiter was approximately 15%, most of these goiters having been identified ten or more years after thyroidectomy. More extensive surgery lowered the recurrence rate but increased the risk of subclinical-hypothyroidism. No statistical significant differences with regard to serum T3, T4, F T4 and TSH (basal and after TRH) of patients with and without recurrent goiter were found. Thus, the maintenance of a recurrent nontoxic goiter does not seem to depend exclusively on increased serum TSH levels. In one patient, the postoperative treatment with thyroxine did not prevent the appearance of recurrent goiter. Since most patients who underwent thyroidectomy remain euthyroid and the goiter recurs in only a small number, the routine postoperative use of thyroid hormone for the prophylaxis of multinodular goiter recurrence seems to be questionable.
对1970年至1983年期间因非毒性多结节性甲状腺肿接受部分甲状腺切除术的39例患者的术后甲状腺肿复发及垂体-甲状腺功能进行了评估，以探寻甲状腺功能、手术范围与甲状腺肿复发之间的关系。甲状腺肿复发率约为15%，其中大多数甲状腺肿是在甲状腺切除术后十年或更长时间才被发现的。手术范围越大，复发率越低，但亚临床甲状腺功能减退的风险增加。复发甲状腺肿患者与未复发甲状腺肿患者的血清T3、T4、FT4及TSH（基础值及TRH刺激后）未发现有统计学显著差异。因此，复发性非毒性甲状腺肿的维持似乎并非仅取决于血清TSH水平升高。有1例患者，术后使用甲状腺素治疗未能预防复发性甲状腺肿的出现。由于大多数接受甲状腺切除术的患者仍保持甲状腺功能正常，只有少数患者甲状腺肿复发，因此常规术后使用甲状腺激素预防多结节性甲状腺肿复发似乎存在疑问。
