摘要:目的: 探討兒童慢性淋巴細(xì)胞性甲狀腺炎的臨床特點(diǎn)、診斷方法、治療及預(yù)后。 方法 : 對(duì)77例CLT患兒的臨床資料進(jìn)行回顧性分析。 結(jié)果 : 77例CLT患兒男女比例1:67,平均年齡1021±233歲(5～15歲)。86％患兒有甲狀腺腫大;初診時(shí)表現(xiàn)甲亢患兒51例,甲低20例,甲功正常6例; TGAb陽(yáng)性率的94％,TPOAb陽(yáng)性率96％;1例甲狀腺細(xì)針吸取細(xì)胞學(xué)檢查診斷合并甲狀腺乳頭狀癌。治療隨訪1～39月,77例患兒中出現(xiàn)甲低37例。 結(jié)論 : 兒童CLT多見(jiàn)于青春期女性,兒童和青春期患者病初表現(xiàn)甲亢較成人多見(jiàn),TGAb 和TPOAb是CLT診斷的重要指標(biāo),隨著病程延長(zhǎng),表現(xiàn)甲低患兒比例逐漸增高。Abstract: Objective: To study the clinical feature, diagnosis, treatment and prognosis of Chronic lymphocytic thyroiditis in children. Methods : Analyze the clinical data of 77 children with Chronic lymphocytic thyroiditis. Results : The proportion of men to women was 1:67 in all 77 children, and the mean age at diagnosis was 1021±233(age range 5~15 years). The percentage of positive TGAb and TPOAb were 94% and 96%, respectively in all the 77 children. One children was diagnosed Chronic lymphocytic thyroiditis coexistent with thyroid papillary carcinoma by FNAB. There were 37 children had hypothyrodism in all the 77 after 1～39 months. Conclusion : CLT is more frequent in females, and at the time of diagnosis more children and adolescents had hypethyrodism than adults. TGAb and TPOAb are important markers for the diagnosis of CLT. The percentage of children had hypothyrodism is increasing along with the course of disease.
目的 了解喉不返神經(jīng)臨床解剖特點(diǎn)，總結(jié)甲狀腺手術(shù)中預(yù)防其損傷的經(jīng)驗(yàn)。方法 分析2例喉不返神經(jīng)臨床資料，結(jié)合文獻(xiàn)討論甲狀腺手術(shù)中預(yù)防其損傷的有關(guān)問(wèn)題。結(jié)果 本組2例經(jīng)手術(shù)證實(shí)，喉不返神經(jīng)均位于右側(cè)； 右喉返神經(jīng)缺如，術(shù)中未損傷。結(jié)論 甲狀腺手術(shù)中發(fā)現(xiàn)橫行于頸動(dòng)脈鞘和喉之間任何索狀結(jié)構(gòu)或探查喉返神經(jīng)缺如，須顯露迷走神經(jīng)(頸段)以避免損傷喉不返神經(jīng)。