甲状腺功能亢进并低钾性周期性麻痹:附121例报告

Treatment of hyperthyroidism associated with hypokalemic periodic paralysis

目的探讨甲状腺功能亢进(甲亢)合并低钾性周期性麻痹手术治疗的临床疗效。方法回顾性分析121例甲亢合并低钾性周期性麻痹患者的临床资料,其中8l例患者在甲亢中毒症状控制并口服碘剂2周后,行双侧甲状腺大部分切除术(手术组);40例患者行非手术治疗(非手术组)。结果手术组患者术后1周复查血清中K+,T3,T4,TSH水平以及基础代谢率(BMR)均恢复正常,追踪随访0.5～10年仅2例复发,治愈率为97.5%;非手术组患者治愈8例,治愈率20.0%。结论对于甲亢合并低钾性周期性麻痹,手术治疗可同时治愈甲亢及周期性麻痹,具有疗效快而稳定的优点,明显优于非手术治疗。

Objective To investigate the etfeet of operation for hyperthyroidism assoiciated with hypokalemie periodic paralysis （HPP） . Methods We retrospectively analysed the clinical data of 1 21 cases of hyperthy- oidism associated with HPP. Among them 81 patients received subtotal thyroideetomy after taking Lugol solu- tion for 2 weeks ;40 patients received non-operative therapy. Results The plasma potassium, T3 , T4 , TSH and BMR levels of patients who received subtotal thyroidectomy were all normal 1 week post-operatively, Only 2 patients suffered symptoms of relapse at follow up of 0.5 - 10 years, with cure rate of 97.5 % ; 8 of the patients who received non-operative therapy recovered, with eure rate of 20.0% . Conclusions Operation for hyperthyroidism associated with HPP couhl cure HPP and hyperthyroidism simultanenusly. The therapeutic efficacy of operation is rapid and stable, and is markedly better than that of non-operative therapy.