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NEJM：甲状腺肿患者的Pemberton征-病例报道

2018-05-31 xing.T MedSci原创

甲状腺肿患者Pemberton征
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Pemberton征出现提示胸腔入口阻塞而引起的上腔静脉综合征。

患者为一名77岁的男子，转诊至内分泌科就亚临床甲状腺功能亢进症进行评估。他没有甲状腺毒症的症状，也没有提示气管受压的呼吸困难或发音障碍症状。

体格检查显示甲状腺肿大，无明显结节或颈部淋巴结肿大（如图A所示）。可以明显观察到Pemberton征-双臂抬高后出现可逆的面部挤塞（如图B所示）。血浆促甲状腺激素水平为0.2mIU/L（参考范围为0.4至4.4），并且血清游离甲状腺素水平正常。颈部计算机断层扫描显示甲状腺肿大，压迫锁骨下静脉和颈静脉（如图C所示），气管偏向左侧（如图C箭头所示）。



Pemberton征出现提示胸腔入口阻塞而引起的上腔静脉综合征。

该患者接受了简单的全甲状腺切除术，病理分析中观察到良性甲状腺肿。他接受了甲状腺激素治疗，手术后6个月随访时，患者甲状腺功能正常。

原始出处：
 
Yazan Abu-Shama,et al.Pemberton’s Sign in a Patient with a Goiter.N Engl J Med 2018. https://www.nejm.org/doi/full/10.1056/NEJMicm1712263
 
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    2019-02-10 vera_1213

    #甲状腺肿#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1705170, encodeId=43741e05170f4, content=<a href='/topic/show?id=7e8469910bc' target=_blank style='color:#2F92EE;'>#甲状腺肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69910, encryptionId=7e8469910bc, topicName=甲状腺肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80aa30947111, createdName=vera_1213, createdTime=Sun Feb 10 05:42:00 CST 2019, time=2019-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1727340, encodeId=ec021e2734067, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Sat Jul 07 12:42:00 CST 2018, time=2018-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321346, encodeId=fa4b321346e4, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Jun 04 07:42:24 CST 2018, time=2018-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=320223, encodeId=7eb932022326, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu May 31 08:37:03 CST 2018, time=2018-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=320214, encodeId=7a20320214e0, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu May 31 08:33:29 CST 2018, time=2018-05-31, status=1, ipAttribution=)]
    2018-07-07 feather89

    #PE#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1705170, encodeId=43741e05170f4, content=<a href='/topic/show?id=7e8469910bc' target=_blank style='color:#2F92EE;'>#甲状腺肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69910, encryptionId=7e8469910bc, topicName=甲状腺肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80aa30947111, createdName=vera_1213, createdTime=Sun Feb 10 05:42:00 CST 2019, time=2019-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1727340, encodeId=ec021e2734067, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Sat Jul 07 12:42:00 CST 2018, time=2018-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=321346, encodeId=fa4b321346e4, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3da1990174, createdName=yfjms, createdTime=Mon Jun 04 07:42:24 CST 2018, time=2018-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=320223, encodeId=7eb932022326, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Thu May 31 08:37:03 CST 2018, time=2018-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=320214, encodeId=7a20320214e0, content=学习了很有用不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu May 31 08:33:29 CST 2018, time=2018-05-31, status=1, ipAttribution=)]
    2018-06-04 yfjms

    学习

    0

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    2018-05-31 明月清辉

    谢谢分享.学习了

    0

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    2018-05-31 飛歌

    学习了很有用不错

    0