摘要
目的回顾性分析尿毒症继发甲状旁腺功能亢进症(secondary hyperparathyroidism,SHPT)患者合并甲状腺疾病的临床特点,探讨尿毒症继发甲状旁腺功能亢进症患者术前行甲状腺B超或甲状腺CT检查对发现甲状腺疾病的价值。方法收集2016年1月-2018年1月本院手术治疗的32例SHPT患者的临床资料(术前B超、CT、术后病理等),其中中合并甲状腺疾病20例,无合并甲状腺疾病12例的,观察术后病理情况与术前检查符合情况。结果无甲状腺疾病SHPT组12例中,3例术前B超提示异常,但术中探查未见肿物,切除相应部位送术中冰冻亦未见异常,1例术前双源CT提示肿物,但B超未报告,术中探查未见肿物,切除相应部位送术中冰冻亦未见异常。合并甲状腺疾病的20例患者中,17例B超报告甲状腺异常,术后病理证实结节性甲状腺肿13例,甲状腺微小乳头状癌2例,桥本氏甲状腺炎1例,嗜酸性腺瘤1例。3例B超未见甲状腺异常的病例均为结节性甲状腺肿。3例B超未见甲状腺异常的病例中,术前CT检查2例亦未见异常。尿毒症继发甲状旁腺功能亢进症患者行CT与B超检查甲状腺疾病的灵敏度和特异度比较差异无统计学意义(P> 0.05)。合并甲状腺疾病20例中,结节性甲状腺肿有16例,占50.00%;嗜酸性腺瘤有1例,占3.13%;桥本氏甲状腺炎1例,占3.13%;甲状腺乳头状癌2例,占6.25%。结论尿毒症继发甲状旁腺功能亢进症患者术前常规行甲状腺B超或甲状腺CT检查对发现甲状腺疾病有重要价值。尿毒症继发甲状旁腺功能亢进症患者常合并其他甲状腺疾病,其中结节性甲状腺肿、甲状腺癌患病率较高。
Objective To retrospectively analyze the clinical characteristics of uremic patients with secondary hyperthyroidism combined with thyroid diseases,and to explore the value of preoperative thyroid B ultrasound or thyroid CT examination in the detection of thyroid diseases in uremic patients with secondary hyperthyroidism.Methods The clinical data(preoperative B-ultrasound,CT,postoperative pathology,etc.)of 32 patients with thyroid diseases in our hospital from January 2016 to January 2018 were collected,including 20 patients with thyroid diseases and 12 patients without thyroid diseases,retrospectively.The postoperative pathology and preoperative examination were observed.Results Among the 12 cases of SHPT group without thyroid disease,3 cases showed abnormal color Doppler ultrasound before operation,but no tumor was found during operation exploration,no abnormal freezing was found during operation when the corresponding part was removed,1 case showed tumor by dual source CT before operation,but the color Doppler ultrasound was not reported,no tumor was found during operation exploration,and no abnormal freezing was found during operation when the corresponding part was removed.Among the 20 patients with thyroid diseases,17 cases reported thyroid abnormalities by color Doppler ultrasound,13 cases of nodular goiter,2 cases of papillary carcinoma,1 case of Hashimoto's thyroiditis and 1 case of eosinophilic adenoma.Three cases without thyroid abnormality were nodular goiter.Among the 3 cases without thyroid abnormality by color Doppler ultrasound,2 cases without thyroid abnormality by CT examination before operation.There was no significant difference in the sensitivity and specificity of thyroid disease between patients with uremia secondary hyperthyroidism who underwent CT and color Doppler ultrasonography(P>0.05).Among 20 cases with thyroid disease,nodular goiter was found in 16 cases(50.00%),eosinophilic adenoma in 1 case(3.13%),Hashimoto's thyroiditis in 1 case(3.13%),papillary thyroid carcinoma in 2 cases(6.25%).Conclusion It is of great value for the detection of thyroid diseases that the patients with uremia secondary hyperparathyroidism were examined by color Doppler ultrasonography or thyroid CT before operation Patients with uremia secondary to hyperparathyroidism often have other thyroid diseases,among which nodular goiter and thyroid cancer have a high incidence.
作者
邱伟刚
吴鑫泉
QIU Weigang;WU Xinquan(Department of Thyroid and Breast Surgery,Second Affiliated Hospital of Fujian Medical University,Quanzhou Fujian 362000,China)
出处
《中国卫生标准管理》
2021年第4期45-48,共4页
China Health Standard Management
基金
中山市医学科研项目(2019A020375)。
