Endocrinology, Diabetes, and Metabolism Feedback Consulting, LLC and Westerville Medical Associates Central Ohio Primary Care Physicians, Inc., Westerville, Ohio 43081, USA.
Thyroid. 2010 Mar;20(3):247-55. doi: 10.1089/thy.2008.0146.
Acute suppurative thyroiditis (AST) resulting from a bacterial infection is an infrequent but potentially life-threatening endocrine emergency. Traditional management of this disease has been surgery in conjunction with targeted antibiotic therapy. Recent nonrandomized reports of small series have demonstrated good outcomes using less invasive approaches. No randomized clinical trials have been performed. Here, we provide a review of the literature and an approach to this problem based on expert opinion.
The literature was reviewed utilizing PubMed, and a representative case of AST was presented to a panel of experts. Endocrinology, surgery, and infectious disease experts responded to a series of questions regarding diagnosis, management, prognosis, and harm.
Combining a broad spectrum of clinical expertise and the published literature, the authors suggest a clinical algorithm as a guide to management, addressing both diagnosis and acute and long-term management.
Published studies indicate a trend toward less invasive management during active inflammation and infection and regarding definite therapy. Remaining questions are presented to foster an evidence-based approach to this disease. Ideally, future randomized, controlled trials will provide data to improve the therapy and outcome of AST.
由细菌感染引起的急性化脓性甲状腺炎（AST）是一种罕见但潜在危及生命的内分泌急症。传统的治疗方法是手术联合靶向抗生素治疗。最近一些小样本的非随机报告表明，采用微创方法可获得良好的效果。目前尚未开展随机临床试验。本文旨在结合文献复习和专家意见，对此问题进行探讨。
利用 PubMed 检索文献，并向专家组展示了 1 例 AST 患者的病例。内分泌、外科和感染病专家回答了一系列关于诊断、治疗、预后和危害的问题。
结合广泛的临床专业知识和已发表的文献，作者提出了一种临床算法作为治疗指南，涵盖了诊断以及急性和长期管理。
已发表的研究表明，在急性炎症和感染期以及确定性治疗期间，倾向于采用微创治疗方法。本文提出了一些仍待解决的问题，以促进对此疾病的循证治疗方法。理想情况下，未来的随机对照试验将提供数据，以改善 AST 的治疗和预后。
