Bürgi U, Comot M G
Abteilung für Endokrinologie und Diabetologie, Medizinische Klinik, Inselspital.
Schweiz Rundsch Med Prax. 1993 Dec 14;82(50):1434-7.
Goiters are most commonly caused by increased, usually nodular growth of thyroid tissue ('simple' goiter), stimulation of thyroid growth by autoantibodies (Grave's disease) or thyroiditis. Rarer causes of goiter are malignant thyroid tumors and hereditary disturbances of thyroid hormone synthesis goiter: due to iodine deficiency should be found no longer in Switzerland because of the adequate iodine supplementation in this country. Differentiating the various types of goiters is usually possible on the basis of clinical signs and a few laboratory tests (e.g. measurement of thyroid antibodies). 'Simple' goiter is usually treated surgically. Hyperthyroid Grave's goiter is primarily treated with thyrostatic drugs, if it recurs; radioiodine of surgery are also used. Subacute thyroiditis causing goiter is treated symptomatically with analgesics anti-inflammatory drugs, while patients with chronic thyroiditis are given thyroid hormones when hypothyroidism occurs. Malignant tumors of the thyroid are treated surgically; in some cases additional therapy with radioiodine is indicated.
甲状腺肿最常见的病因是甲状腺组织增生（通常为结节性）（“单纯性”甲状腺肿）、自身抗体刺激甲状腺生长（格雷夫斯病）或甲状腺炎。甲状腺肿较罕见的病因是甲状腺恶性肿瘤和甲状腺激素合成的遗传性障碍。由于瑞士碘补充充足，因碘缺乏导致的甲状腺肿在该国已不再常见。通常根据临床体征和一些实验室检查（如甲状腺抗体检测）来区分不同类型的甲状腺肿。“单纯性”甲状腺肿通常采用手术治疗。甲状腺功能亢进的格雷夫斯甲状腺肿如果复发，主要用抗甲状腺药物治疗；也会使用放射性碘或手术治疗。由亚急性甲状腺炎引起的甲状腺肿用镇痛药和抗炎药进行对症治疗，而慢性甲状腺炎患者出现甲状腺功能减退时则给予甲状腺激素。甲状腺恶性肿瘤采用手术治疗；在某些情况下，还需进行放射性碘辅助治疗。
