上海医药
上海醫藥
상해의약
SHANGHAI MEDICAL & PHARMACEUTICAL JOURNAL
2015年
7期
6-11
,共6页
甲状腺功能亢进%甲巯咪唑%丙基硫氧嘧啶%放射性碘治疗%甲状腺切除术
甲狀腺功能亢進%甲巰咪唑%丙基硫氧嘧啶%放射性碘治療%甲狀腺切除術
갑상선공능항진%갑구미서%병기류양밀정%방사성전치료%갑상선절제술
hyperthyroidism%methimazole%propylthiouracil%radioactive iodine%thyroidectomy
儿童、青少年甲状腺功能亢进最主要原因是GD,即弥漫性毒性甲状腺肿,药物治疗复发率很高。抗甲状腺药物(ATD)中,首选甲巯咪唑(MMI),丙硫氧嘧啶(PTU)因可能导致严重肝脏损害仅在特殊临床情况下使用。如果ATD治疗没有缓解病情,可考虑行放射性131I治疗或手术。使用131I治疗时,剂量应当大于150 mCi/g甲状腺组织。在儿童、青少年治疗中应当避免小剂量131I治疗。手术行甲状腺近全切或全切时,其并发症在儿童及青少年患者中比成人高,因此予以儿童及青少年手术时,需由有经验的甲状腺外科手术医生实施。
兒童、青少年甲狀腺功能亢進最主要原因是GD,即瀰漫性毒性甲狀腺腫,藥物治療複髮率很高。抗甲狀腺藥物(ATD)中,首選甲巰咪唑(MMI),丙硫氧嘧啶(PTU)因可能導緻嚴重肝髒損害僅在特殊臨床情況下使用。如果ATD治療沒有緩解病情,可攷慮行放射性131I治療或手術。使用131I治療時,劑量應噹大于150 mCi/g甲狀腺組織。在兒童、青少年治療中應噹避免小劑量131I治療。手術行甲狀腺近全切或全切時,其併髮癥在兒童及青少年患者中比成人高,因此予以兒童及青少年手術時,需由有經驗的甲狀腺外科手術醫生實施。
인동、청소년갑상선공능항진최주요원인시GD,즉미만성독성갑상선종,약물치료복발솔흔고。항갑상선약물(ATD)중,수선갑구미서(MMI),병류양밀정(PTU)인가능도치엄중간장손해부재특수림상정황하사용。여과ATD치료몰유완해병정,가고필행방사성131I치료혹수술。사용131I치료시,제량응당대우150 mCi/g갑상선조직。재인동、청소년치료중응당피면소제량131I치료。수술행갑상선근전절혹전절시,기병발증재인동급청소년환자중비성인고,인차여이인동급청소년수술시,수유유경험적갑상선외과수술의생실시。
Graves’ disease (GD) is the most common cause of hyperthyroidism in children and adolescents, and has a high rate of relapse. Methimazole (MMI) is preferred when the antithyroid drugs (ATD) are prescribed. Propylthiouracil (PTU) may lead to serious liver damage and therefore should be avoided in clinic, however, there is a role for its limited use in special circumstances. If ATD treatment can not alleviate thyrotoxicosis,131I therapy or surgery should be considered. The dose of131I should be used at greater than 150 mCi/g of the thyroid tissue when applied in the treatment, however the low-dosages 131I treatment in children and adolescents should be avoided. When near total or total-thyroidectomy is performed, the incidence of the complications resulting from surgery is higher in children and adolescents than in adults. Thus, the experienced thyroid surgeons are required when children and adolescents are going to be operated.