Berghout A, Wiersinga W M, Drexhage H A, van Trotsenburg P, Smits N J, van der Gaag R D, Touber J L
Department of Medicine, University of Amsterdam, The Netherlands.
Clin Endocrinol (Oxf). 1989 Aug;31(2):193-9. doi: 10.1111/j.1365-2265.1989.tb01242.x.
To study the long-term outcome after thyroidectomy, 113 sporadic non-toxic goitre patients who underwent thyroidectomy in our hospital in the period 1974-1983, were studied. Five patients complained of recurrent goitre; a goitre was found on inspection and palpation in these five and in 15 others. There were no differences between the 20 patients with goitre and the 93 patients without goitre with regard to sex, age, duration of goitre, indication and type of thyroidectomy, postoperative thyroid hormone medication, period of follow-up, and T4, T3, or TSH plasma values at the time of follow-up examination. Twenty-three patients complained of voice changes since thyroidectomy. In a case control study, included in this follow-up study, 19 patients with goitre, i.e. thyroid size I and II as estimated by inspection and palpation (cases), and 16 patients without goitre, i.e. thyroid size OA and OB (controls), were studied in more detail. No difference between cases and controls was found in any of the above mentioned parameters that could explain the recurrence of goitre. Thyroid volume (median) was greater in the cases (34.1 ml, range 7.9-83.4) than in the controls (10.3 ml, range 2.5-48.7) (P less than 0.001), although a considerable overlap between the two groups was observed. One or more thyroid nodules were found in 89.5% of the cases and in 62.5% of the controls (NS). Serum thyroid growth stimulating immunoglobulin (TGI) was present both in cases (68%) and controls (50%). TGI was present in high titres in all five patients who complained about recurrent goitre.(ABSTRACT TRUNCATED AT 250 WORDS)
为研究甲状腺切除术后的长期预后,我们对1974年至1983年期间在我院接受甲状腺切除术的113例散发性非毒性甲状腺肿患者进行了研究。5例患者主诉甲状腺肿复发;经检查和触诊,这5例以及另外15例发现有甲状腺肿。甲状腺肿患者组(20例)和无甲状腺肿患者组(93例)在性别、年龄、甲状腺肿病程、甲状腺切除的指征和类型、术后甲状腺激素用药情况、随访时间以及随访检查时的血浆T4、T3或TSH值方面均无差异。23例患者主诉自甲状腺切除术后出现声音改变。在本次随访研究纳入的一项病例对照研究中,对19例有甲状腺肿的患者(即经检查和触诊估计甲状腺大小为I度和II度,病例组)和16例无甲状腺肿的患者(即甲状腺大小为OA度和OB度,对照组)进行了更详细的研究。在上述任何可解释甲状腺肿复发的参数方面,病例组和对照组均未发现差异。病例组的甲状腺体积(中位数)(34.1 ml,范围7.9 - 83.4)大于对照组(10.3 ml,范围2.5 - 48.7)(P < 0.001),尽管两组之间存在相当大的重叠。89.5%的病例组和62.5%的对照组发现有一个或多个甲状腺结节(无显著性差异)。病例组(68%)和对照组(50%)均存在血清甲状腺生长刺激免疫球蛋白(TGI)。所有5例主诉甲状腺肿复发的患者TGI均呈高滴度。(摘要截短于250字)