中文摘要：

目的探讨结节性甲状腺肿伴结节内出血与亚急性甲状腺炎的临床鉴别。方法以3例结节性甲状腺肿伴结节内出血病例的诊治资料,回顾性分析其临床表现、诊断及治疗,并讨论其与亚急性甲状腺炎的临床鉴别要点。结果 3例患者在结节内出血急性期有突发甲状腺肿痛、发热、血沉升高、甲状腺摄131I降低以及一过性甲状腺功能异常等类似亚急性甲状腺炎的临床表现,通过甲状腺B超和甲状腺细针穿刺活检可确诊为结节性甲状腺肿伴结节内出血。其中2例患者行手术治疗,另1例暂未行手术治疗,患者经随访甲状腺功能均恢复正常。结论结节性甲状腺肿伴结节内出血急性期易误诊为亚急性甲状腺炎,两者的鉴别诊断可有效避免糖皮质激素的误用。

英文摘要：

Objective To explore the differentiate points between hemorrhagic degeneration of nodular goiters and subacute thyroiditis.Method The clinical features,diagnosis and treatment of the hemorrhagic degeneration of nodular goiter in three patients were restrospectively analyzed,and the differential diagnosis with subacute thyroiditis was discussed.Resluts Patients demonstrated subacute thyroiditis-like symptoms including abrupt pain and swelling of the thyroid,fever,accelerated erythrocyte sedimentation rate,lower thyroidal radioactive iodine uptake and transient thyroid dysfunction.Through ultrasonography and fine needle aspiration biopsy patients were diagnosed as hemorrhagic degenerarion of nodular goiter.Two cases received operation procedure and one case received non-operation treatment,patients were recovery of thyroid dysfunction in follow up.Conclusion Acute hemorrhagic degeneration of nodular goiter is easily misdiagnosed as subacute thyroiditis.The differential diagnosis is necessary for avoiding misuse of glucocorticoids.