顽固性甲状腺机能亢进症的介入治疗

Interventional embolization for refractory hyperthyroidism

目的 探讨甲状腺动脉栓塞治疗顽固性甲状腺机能亢进症的临床价值。方法 超选择性插管至甲状腺上、下动脉 ,采用PVA微球及明胶海绵栓塞治疗。栓塞后观察甲状腺功能及大小的变化。结果 2 1例甲状腺动脉栓塞均成功。随访 3～ 12个月 ,血清FT3 中位值自 17.1pmol/L降至 7.44 pmol/L ,FT4 中位值自 5 1.1pmol/L降至 2 3.3pmol/L(P <0 .0 1) ,甲状腺明显缩小 ,4例停服抗甲状腺药物 ,17例服少量抗甲状腺药物维持。无严重并发症。

Objective To evaluate the clinical effects of the thyroid artery embolization for refractory hyperthyroidism. Methods Superselective catheterization and interventional embolization of thyroid superior and inferior arteries were performed with PVA microspheres and Gelfoam particles. Changes of function and size of thyroid were investigated after embolization. Results The procedures were succeeded in all 21 patients. Followed up by 3～12 months, serum level of thyroid hormones dropped significantly (median FT 3from 17.1 pmol/L to 7.44pmol/L, median FT 4 from 51.1pmol/L to 23.3pmol/L, P <0.01). The size of thyroid glands decreased remarkably . Symptoms of hyperthyroidism were controlled in 4 patients and were effectively controlled through low dose antithyroid medication in 17 patients. No serious complications occured. Conclusions Thyroid artery embolization is a new safe and effective method for refractory hyperthyroidism.