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目的探讨原发性甲状腺功能减退症的临床误诊原因及预防。方法回顾分析29例患者的临床资料。结果所有患者给予口服左旋甲状腺激素治疗,剂量从12.5μg/d开始,每1～2周加量12.5～25μg,直至维持量50～150μg/d,根据不同个体反应的情况调整用量,辅予对症治疗,定期检测甲功、心电图、超声心动图等;经6周～3个月治疗,患者的临床症状及体征消退,各项辅助检查指标恢复正常。结论临床医师应仔细询问病史,临床检查一定要认真且全面,查体时要注意甲状腺的检查,因不少患者存在不同程度的甲状腺肿大;对出现不明原因的胸闷、乏力、畏寒、贫血、便秘、水肿等症状时,应想到甲减的可能,常规查甲状腺功能;提高对临床辅助检查的认识,这对尽早作出正确诊断非常重要,及早诊治,以改善预后。
Objective To investigate the causes and prevention of clinical misdiagnosis of primary hypothyroidism. Methods The clinical data of 29 patients were retrospectively analyzed. Results All patients were given oral levothyroxine treatment. The dosage was 12.5μg / d, 12.5 ~ 25μg every 1 ~ 2 weeks until the maintenance dose was 50 ~ 150μg / d. According to different individual reactions, Regular test of thyroid function, electrocardiogram, echocardiography, etc .; after 6 weeks to 3 months of treatment, the patient’s clinical symptoms and signs subsided, the auxiliary examination indicators returned to normal. Conclusion Clinicians should carefully ask the medical history, clinical examination must be serious and comprehensive, physical examination should pay attention to the thyroid examination, because there are many patients with varying degrees of goiter; unexplained chest tightness, fatigue, chills, anemia , Constipation, edema and other symptoms, you should think of the possibility of hypothyroidism, routine examination of thyroid function; improve the understanding of clinical laboratory tests, which make the right diagnosis as soon as possible is very important, early diagnosis and treatment to improve the prognosis.