航空航天医学杂志
航空航天醫學雜誌
항공항천의학잡지
AEROSPACE MEDICINE
2014年
5期
604-606
,共3页
宁志方%张莉%巩芳伟%陶智慧
寧誌方%張莉%鞏芳偉%陶智慧
저지방%장리%공방위%도지혜
弥漫性毒性甲状腺肿%介入治疗%动脉栓塞治疗%甲状腺功能亢进
瀰漫性毒性甲狀腺腫%介入治療%動脈栓塞治療%甲狀腺功能亢進
미만성독성갑상선종%개입치료%동맥전새치료%갑상선공능항진
Graves′disease%Interventional%Arterial embolism%Hyperthyroidism
目的：探讨采用甲状腺动脉栓塞方法治疗弥漫性毒性甲状腺肿（ Graves病）的疗效及临床意义。方法筛选30例Graves病患者，经动脉造影明确甲状腺动脉的位置及血供情况，超选入甲状腺上动脉或下动脉内用聚乙烯醇微球进行栓塞治疗，并观察其疗效。结果30例全部栓塞成功，16例栓塞双侧甲状腺上动脉，11例栓塞双侧甲状腺上动脉加单侧下动脉，3例栓塞一侧甲状腺上动脉。栓塞前后测定血清甲状腺激素，30例患者T3由3.4～41.2 nmol/L降至0.9～8.1 nmol/L；T4由79.1～436.3 nmol/L降至62.2～236.9 nmol/L；栓塞后颈部血管杂音完全消失，颈围于术后1天开始缩小，2周左右达到稳定状态。随访6个月～2年，20例完全停药，6例间断服药6个月，症状消失，未出现复发；4例随访1年，间断服用抗甲状腺药物，症状得到有效控制。所有病例未见发生甲状腺功能低下。结论甲状腺动脉栓塞术是治疗甲亢引起的Graves病有效的微创治疗方法。
目的：探討採用甲狀腺動脈栓塞方法治療瀰漫性毒性甲狀腺腫（ Graves病）的療效及臨床意義。方法篩選30例Graves病患者，經動脈造影明確甲狀腺動脈的位置及血供情況，超選入甲狀腺上動脈或下動脈內用聚乙烯醇微毬進行栓塞治療，併觀察其療效。結果30例全部栓塞成功，16例栓塞雙側甲狀腺上動脈，11例栓塞雙側甲狀腺上動脈加單側下動脈，3例栓塞一側甲狀腺上動脈。栓塞前後測定血清甲狀腺激素，30例患者T3由3.4～41.2 nmol/L降至0.9～8.1 nmol/L；T4由79.1～436.3 nmol/L降至62.2～236.9 nmol/L；栓塞後頸部血管雜音完全消失，頸圍于術後1天開始縮小，2週左右達到穩定狀態。隨訪6箇月～2年，20例完全停藥，6例間斷服藥6箇月，癥狀消失，未齣現複髮；4例隨訪1年，間斷服用抗甲狀腺藥物，癥狀得到有效控製。所有病例未見髮生甲狀腺功能低下。結論甲狀腺動脈栓塞術是治療甲亢引起的Graves病有效的微創治療方法。
목적：탐토채용갑상선동맥전새방법치료미만성독성갑상선종（ Graves병）적료효급림상의의。방법사선30례Graves병환자，경동맥조영명학갑상선동맥적위치급혈공정황，초선입갑상선상동맥혹하동맥내용취을희순미구진행전새치료，병관찰기료효。결과30례전부전새성공，16례전새쌍측갑상선상동맥，11례전새쌍측갑상선상동맥가단측하동맥，3례전새일측갑상선상동맥。전새전후측정혈청갑상선격소，30례환자T3유3.4～41.2 nmol/L강지0.9～8.1 nmol/L；T4유79.1～436.3 nmol/L강지62.2～236.9 nmol/L；전새후경부혈관잡음완전소실，경위우술후1천개시축소，2주좌우체도은정상태。수방6개월～2년，20례완전정약，6례간단복약6개월，증상소실，미출현복발；4례수방1년，간단복용항갑상선약물，증상득도유효공제。소유병례미견발생갑상선공능저하。결론갑상선동맥전새술시치료갑항인기적Graves병유효적미창치료방법。
O bjective To investigate the clinical significance and effect of Arterial embolization of thyroid gland for treating Diffuse toxic goiter ( Graves′disease).Methods 30 cases of Graves′disease patients were selected , to clear the blood supply of thyroid arteries with artery angiography , then super selecte the superior thyroid artery or arteries for the embolization with polyvinyl alcohol microspheresis.The efficacy and complications of the therapy were ob-served.Results The therapy was effect in all of the 30 cases.16cases was embolized by bilateral superior thyroid arter-ies,11 cases by bilateral superior thyroid arteries and one -side inferior thyroid artery , 3cases by one-side superior thy-roid artery.The determination of serum thyroxine before and after therapy , T3of 30 cases decreased from 3.4 ~41.2 nmol/L to 0.9~8.1 nmol/L T4 of 30 cases decreased from 79.1~436.3 nmol/L to 62.2~236.9 nmol/L.Cervi-cal bruits disappeared after therapy.Neck circumference narrowed from the first day after therapy , and reached a steady state about 2 weeks.Follow up between 6 months to 2 years, 20 cases of complete withdrawal;6 cases of intermittent medication for 6 months , and the symptoms disappeared without recurrence , 4 cases taked antithyroid drugs discontinu-ously, and the symptoms were effectively controlled in one year.No cases occurd hypothyroidism.Conclusions Arterial embolization of thyroid gland is a effective minimally invasive treatment to Graves′disease caused by hyperthyroidism.
