Heberling H J, Heintze M, Kuhlmann E, Lohmann D, Hartig W, Mättig H
Dtsch Med Wochenschr. 1984 Nov 16;109(46):1757-60. doi: 10.1055/s-2008-1069448.
Bilateral subtotal resection or enucleation or unilateral resection was performed in 60 patients (36 with bland nodular goitre, 24 with autonomic adenoma). The thyrotropic pituitary activity and the peripheral thyroid function were examined in all patients preoperatively and followed up for 12 months postoperatively. The results show that all patients with bilaterally resected bland nodular goitre require postoperative administration of thyroid hormone, since enhanced thyrotropic activity is seen not later than three months after surgery. Since thyrotropic function remains normal in unilaterally operated nodular goitre, thyroid hormone administration does not appear generally necessary. In patients with autonomic adenoma there is postoperatively variability of function, independent of the surgical method employed. In view of possible functional recompensation, final decision on the administration of thyroid hormones should not be made before the end of the sixth postoperative month. These results can be considered as guidelines for a differentiated postoperative management.
60例患者(36例为单纯结节性甲状腺肿,24例为自主性腺瘤)接受了双侧次全切除或摘除术或单侧切除术。术前对所有患者的促甲状腺垂体活性和外周甲状腺功能进行了检查,并在术后随访12个月。结果显示,所有双侧切除单纯结节性甲状腺肿的患者术后都需要服用甲状腺激素,因为术后不迟于三个月即可观察到促甲状腺活性增强。由于单侧手术的结节性甲状腺肿患者的促甲状腺功能保持正常,一般看来无需服用甲状腺激素。自主性腺瘤患者术后功能存在变异性,与所采用的手术方法无关。鉴于可能存在功能代偿,术后第六个月末之前不应就甲状腺激素的服用做出最终决定。这些结果可被视为差异化术后管理的指导原则。