Vetshev P S, Chilingaridi K E, Bannyĭ D A, Dmitriev E E
Khirurgiia (Mosk). 2004(8):37-40.
Medical histories of 214 patients hospitalized with diagnosis "recurrent nodular goiter" were studied retrospectively. Complex clinical, laboratory and instrumental examination was carried out in all the patients. Comparative analysis demonstrated that in the structure of recurrent goiter nodular colloid form dominated (84.1%), only in 42.1% cases repeated surgeries were indicated. Other patients (15.9%) were the ones underwent surgery for other thyroid diseases (hypertrophied form of autoimmune thyroiditis, follicular adenoma, thyroid cysts, thyroid cancer). Inadequate surgery and prophylactic therapy with iodine drugs were the main causes of recurrent goiter. Adequate iodine prophylaxis (potassium iodide 100-200 mg per day), complex examination of patients, correct indications for primary surgery and adequate surgical volume, valuable postoperative therapy (iodine drug, LT-4 if it is necessary) permit to reduce the risk of recurrent nodular (multiple-nodular, diffuse-nodular) goiter. Ways of researches for improvement of diagnosis, prophylaxis and treatment results of "recurrence nodular goiter" are projected.
对214例诊断为“复发性结节性甲状腺肿”的住院患者的病史进行了回顾性研究。对所有患者进行了综合临床、实验室和仪器检查。比较分析表明，在复发性甲状腺肿的结构中，结节性胶体形式占主导（84.1%），仅42.1%的病例需要再次手术。其他患者（15.9%）是因其他甲状腺疾病（自身免疫性甲状腺炎肥大形式、滤泡性腺瘤、甲状腺囊肿、甲状腺癌）接受手术的。手术不充分以及碘剂预防性治疗是复发性甲状腺肿的主要原因。充分的碘预防（每天100 - 200毫克碘化钾）、对患者的综合检查、初次手术的正确指征和足够的手术量、有价值的术后治疗（碘剂、必要时使用LT - 4）可降低复发性结节性（多结节性、弥漫性结节性）甲状腺肿的风险。提出了改善“复发性结节性甲状腺肿”诊断、预防和治疗效果的研究方法。
