Hazard J, Simon D
Service d'Endocrinologie, Hôpital Henri Mondor, Créteil.
Ann Endocrinol (Paris). 1988;49(4-5):306-11.
Early continuous hormonal treatment, inhibiting TSH secretion, reduces the volume of recent homogeneous goiters. This treatment is usually well tolerated, but can induce thyrotoxicosis in subjects with blunted response of TSH to TRH stimulation before treatment. Surgery is used for large goiters, compressive goiters or suspicion of cancer and after failure of the hormonal treatment. In all cases, hormonal treatment must be associated to surgery. Radio-iodine can be used for large or compressive goiters, when surgery is inadvisable. Despite the risk of thyrotoxicosis, iodine addition in food intake is useful to prevent goiters. The frequency of thyrotoxicosis can be decreased by ruling out subjects over 50 years old, with nodular goiters or with blunted response of TSH to TRH stimulation.
早期持续激素治疗可抑制促甲状腺激素（TSH）分泌，缩小近期出现的均匀性甲状腺肿的体积。这种治疗通常耐受性良好，但在治疗前TSH对促甲状腺激素释放激素（TRH）刺激反应迟钝的患者中可能诱发甲状腺毒症。手术用于治疗大的甲状腺肿、有压迫症状的甲状腺肿或怀疑有癌症的情况，以及激素治疗失败后。在所有情况下，激素治疗都必须与手术相结合。当手术不可行时，放射性碘可用于治疗大的或有压迫症状的甲状腺肿。尽管有甲状腺毒症的风险，但在食物摄入中添加碘有助于预防甲状腺肿。通过排除50岁以上、患有结节性甲状腺肿或TSH对TRH刺激反应迟钝的患者，可降低甲状腺毒症的发生率。
