【Abstract】ObjectiveTo summarize the experience in diagnosis and treatment for chronic lymphocytic thyroiditis or complicated with other thyroid diseases. MethodsSeventyseven patients were diagnosed as chronic lymphocytic thyroiditis or complicated with other thyroid diseases by operation and histological examination at this department from November 2002 to March 2005. All their clinical records including general information, the results of careful physical examination, thyroid correlated hormone tests, color Doppler, fine needle aspiration cytological examination and some intraoperative examinations have been retrospectively analyzed in this report. ResultsThere were 53 cases of simple chronic lymphocytic thyroiditis, 10 cases complicated by papillary carcinoma, 1 case complicated by follicular carcinoma, 2 cases complicated by nonHodgkin’s lymphoma, 6 cases complicated by nodular goiter, 4 cases complicated by follicular adenoma, and 1 complicated by parathyroid adenoma. Almost all the operations were successfull and the symptoms of the diseases were alleviated. Seventytwo patients had been followed up ranging from two months to two years differently and none of them relapsed. Sixtythree of these patients have received thyrine inhibition and vicariousness treatment, 2 patients who complicated by nonHodgkin’s lymphoma had been hospitalized and 7 patients complicated by carcinoma were treated with iodine131. ConclusionThe clinical manifestations of chronic lymphocytic thyroiditis are complex, and it often complicated with other thyroid disease, which make it difficult to diagnose the diseases before operation. However, some ancillary methods such as careful physical examination, thyroid correlated hormone tests, color Doppler and fine needle aspiration cytological examination may improve the accuracy of preoperative diagnosis. Intraoperative thyroid lamellar section and frozen histological examination are also very important for intraoperative diagnosis and operative modality selection.
目的 探讨脾脏原发性肿瘤的诊断与治疗方法。方法 对我院1996~2003年收治的22例脾脏原发性肿瘤患者的临床资料进行回顾性分析。结果 22例患者临床症状无特异性,术前均行B超检查,发现脾大21例,提示脾脏占位病变19例,该19例行CT检查,均发现脾大并提示有占位病变。手术病检证实良性肿瘤12例,恶性肿瘤10例。22例患者均行脾切除,其中有5例行淋巴结清扫,2例行侵犯脏器联合切除。结论 脾脏原发性肿瘤术前诊断主要靠B超、CT,其治疗首选外科手术。
目的 比较进展性慢性肝病及重症肝炎患者原位肝移植(OLT)围手术期凝血功能的变化。方法 回顾性分析我中心2004年1月至2005年12月期间行OLT治疗进展性慢性肝病及重症肝炎患者各37例的围手术期血小板(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及纤维蛋白原(FIB)的变化。结果 2组患者除术前PT、APTT,术后第5 d PLT、FIB和术后第7 d FIB的差异有统计学意义外(plt;0.05),其余时段2组患者的PLT、PT、APTT及FIB 间差异均无统计学意义(Pgt;0.05), 提示重症肝炎患者凝血功能损害更为严重; OLT术后,2组患者的凝血功能均逐渐恢复正常, 但并非完全同步。结论 进展性慢性肝病与重症肝炎患者OLT围手术期凝血功能变化显著,应注意监测及处理,但术后2组间各指标间比较差异并不明显。