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1 病例介绍 例1,女,14岁。颈部肿块、疼痛1天入院。查体:甲状腺弥漫性肿大,质硬、触痛,吞咽时上下活动差。T37.6℃,P101次/分,白细胞12.4×10~9/L,NO.84,LO.16。诊断“急性甲状腺肿大(炎症型)”,以青霉素、庆大霉素静滴,症状无缓解。经详询病史,患者既往无颈部包块,1周前有上感史。考虑亚急性甲状腺炎,查血沉65mm/h,T_35.2nmol/L,T_4164n-mol/L,24h甲状腺吸~(131)Ⅰ率 0.1％。确诊后停用抗生素,服强的松5mg,3次/d,1周后甲状腺肿大缩小,患者自行要求出院,嘱其减量服
1 case introduction example 1, female, 14 years old. Neck mass, pain 1 day admission. Physical examination: diffuse thyroid enlargement, hard, tenderness, up and down when swallowing poor activity. T37.6 ℃, P101 times / min, leukocytes 12.4 × 10 ~ 9 / L, NO.84, LO.16. Diagnosis of “acute goiter (inflammation type)” to penicillin, gentamicin intravenous infusion, no relief of symptoms. After detailed inquiry history, the patient had no past neck mass, a sense of the past 1 week ago. Consider subacute thyroiditis, check the sedimentation rate 65mm / h, T_35.2nmol / L, T_4164n-mol / L, 24h thyroid suction ~ (131) Ⅰ rate of 0.1%. After the diagnosis of discontinuing antibiotics, prednisone 5mg, 3 times / d, 1 week after the goiter was reduced, the patient discharged on their own request, ordered reduction of service