摘要
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。
Objective 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.
出处
《航空航天医学杂志》
2014年第5期604-606,共3页
Journal of Aerospace medicine
