Hughes Kiernan, Eastman Creswell
Sydney Thyroid Clinic, New South Wales, Australia.
Aust Fam Physician. 2012 Aug;41(8):572-6.
Goitre refers to an enlarged thyroid. Common causes of goitre include autoimmune disease, thyroid nodules and iodine deficiency.
This article outlines the causes, investigation and management of goitre in the Australian general practice setting.
Patients with goitre may be asymptomatic, or may present with compressive symptoms such as cough or dysphagia. Goitre may also present with symptoms due to associated hypothyroidism or hyperthyroidism. Thyroid stimulating hormone is the appropriate first test for all patients with goitre; if this hormone is low a radionuclide scan is helpful. Thyroid ultrasound has become an extension of physical examination and should be performed in all patients with goitre. Ultrasound can determine what nodules should be biopsied. Treatment options for goitre depend on the cause and the clinical picture and may include observation, iodine supplementation, thyroxine suppression, thionamide medication (carbimazole or propylthiouracil), radioactive iodine ablation and surgery.
甲状腺肿是指甲状腺增大。甲状腺肿的常见病因包括自身免疫性疾病、甲状腺结节和碘缺乏。
本文概述了澳大利亚全科医疗环境中甲状腺肿的病因、检查及管理。
甲状腺肿患者可能无症状，或可能出现如咳嗽或吞咽困难等压迫症状。甲状腺肿也可能因伴有甲状腺功能减退或甲状腺功能亢进而出现症状。促甲状腺激素是所有甲状腺肿患者合适的首选检查；如果该激素水平低，放射性核素扫描会有帮助。甲状腺超声已成为体格检查的延伸，所有甲状腺肿患者均应进行此项检查。超声可确定哪些结节需要活检。甲状腺肿的治疗选择取决于病因和临床表现，可能包括观察、补充碘、甲状腺素抑制、硫酰胺类药物（卡比马唑或丙硫氧嘧啶）、放射性碘消融及手术。
