Eyre-Brook I A, Talbot C H
Br J Surg. 1982 Oct;69(10):577-9. doi: 10.1002/bjs.1800691006.
The clinical features and management of 90 thyrotoxic and 11 euthyroid patients with a single autonomous hot nodule in the thyroid have been reviewed to assess the results of surgery and radio-iodine therapy. Symptoms and signs of thyrotoxicosis were often minimal but histories were frequently long with cardiac complications predominating. Thyrotoxicosis was permanently eradicated in the 60 patients treated surgically, although hypothyroidism occurred in 6.6 per cent. Twelve of the 37 (32 per cent thyrotoxic patients receiving radio-iodine needed further definitive treatment for persistent or recurrent thyrotoxicosis, but only 2 patients (5 per cent) became hypothyroid. Early surgery for the autonomous toxic thyroid nodule ensures control of the thyroid overactivity and minimizes the risk of permanent cardiac damage. The absence of morbidity justifies surgical excision of autonomous hot nodules in patients who are euthyroid to eliminate the risk of thyrotoxicosis supervening.
回顾了90例甲状腺毒症患者和11例甲状腺功能正常但有单个自主性热结节患者的临床特征及治疗情况，以评估手术和放射性碘治疗的效果。甲状腺毒症的症状和体征通常很轻微，但病史往往较长，心脏并发症较为突出。60例接受手术治疗的患者甲状腺毒症得到了永久性根除，尽管有6.6%的患者出现了甲状腺功能减退。37例接受放射性碘治疗的甲状腺毒症患者中有12例（32%）因持续性或复发性甲状腺毒症需要进一步的确定性治疗，但只有2例（5%）出现甲状腺功能减退。对自主性毒性甲状腺结节进行早期手术可确保控制甲状腺功能亢进，并将永久性心脏损害的风险降至最低。对于甲状腺功能正常的患者，手术切除自主性热结节不存在并发症，可消除发生甲状腺毒症的风险。
