Young R L, Nusynowitz M L
Semin Nucl Med. 1979 Apr;9(2):85-94. doi: 10.1016/s0001-2998(79)80039-2.
The treatment of benign forms of thyroid disease is reviewed. Endemic goiter is a public health problem preventable by the addition of iodine to the food or water supply. Endemic and familial goiters are treated with replacement doses of I-thyroxine, as are sporadic colloid goiters and goiters resulting from chronic thyroiditis. Hyperfunctioning autionomous nodules without thyrotoxicosis and cystic nodules require no specific therapy. Prophylaxis against diffuse or nodular goiter after radiation to the head or neck for therapeutic purposes with thyroxine replacement therapy is debatable. All forms of hypothyroidism, including incipient types, require replacement thyroxine therapy, but this should be undertaken cautiously in older patients and in those with evidence of ischemic myocardial disease. Myxedema coma requires vigorous treatment and detailed supervision because of dismal mortality rates. Iodine 131 is the treatment of choice in diffuse toxic goiter, but alternative forms.
本文综述了甲状腺良性疾病的治疗方法。地方性甲状腺肿是一个可通过在食物或水源中添加碘来预防的公共卫生问题。地方性和家族性甲状腺肿采用补充剂量的左旋甲状腺素进行治疗，散发性胶质性甲状腺肿和慢性甲状腺炎所致的甲状腺肿也是如此。无甲状腺毒症的功能自主性高功能结节和囊性结节无需特殊治疗。对于因治疗目的对头颈部进行放射后预防弥漫性或结节性甲状腺肿，采用甲状腺素替代疗法存在争议。所有形式的甲状腺功能减退，包括早期类型，都需要进行甲状腺素替代治疗，但对于老年患者和有缺血性心肌病证据的患者，应谨慎进行。黏液性水肿昏迷由于死亡率高，需要积极治疗和详细监护。放射性碘131是弥漫性毒性甲状腺肿的首选治疗方法，但也有其他替代形式。
