Bürgi U, Studer H
Schweiz Med Wochenschr. 1986 Mar 15;116(11):326-31.
Studies in Switzerland (1979), in Austria (1982) and in Germany (1975) revealed that greater than 10% of the population has a goiter. Simple guidelines are offered to the practising physician for the work-up and therapy of this fairly common pathological condition. In the work-up one investigates firstly whether the goiter in question could be malignant, and, secondly, whether it could be due to thyroiditis. If this is not the case the goiter is probably benign (Graves' goiter or "simple" goiter). Malignant goiters are referred to the endocrinologist/surgeon for further work-up and therapy. Subacute thyroiditis is treated with salicylates or steroids. The hyperthyroid phase of thyroiditis is treated with beta-blockers and possibly steroids and the hypothyroid phase with thyroxine. The hypo- and euthyroid variants of "simple" goiter are treated with thyroxine. Goiters which grow during this therapy are removed surgically. The hyperthyroid variant of "simple" goiter should preferably be treated surgically.
瑞士(1979年)、奥地利(1982年)和德国(1975年)的研究表明,超过10%的人口患有甲状腺肿。针对这种相当常见的病理状况,为执业医师提供了简单的检查和治疗指南。在检查过程中,首先要调查所讨论的甲状腺肿是否可能是恶性的,其次要调查它是否可能是由甲状腺炎引起的。如果不是这种情况,甲状腺肿可能是良性的(格雷夫斯甲状腺肿或“单纯性”甲状腺肿)。恶性甲状腺肿会被转介给内分泌科医生/外科医生进行进一步的检查和治疗。亚急性甲状腺炎用水杨酸盐或类固醇治疗。甲状腺炎的甲亢期用β受体阻滞剂治疗,可能还会使用类固醇,甲减期用甲状腺素治疗。“单纯性”甲状腺肿的甲减和甲功正常变体用甲状腺素治疗。在这种治疗过程中生长的甲状腺肿通过手术切除。“单纯性”甲状腺肿的甲亢变体最好通过手术治疗。