卢戈氏液联合地塞米松在射频消融治疗原发甲亢术前准备的应用

Application of Lugo's solution combined with dexamethasone in preoperativepreparation of radiofrequency ablation for primary hyperthyroidism

目的探讨卢戈氏液联合地塞米松在射频消融(RFA)治疗原发性甲状腺功能亢进症(简称甲亢)术前准备的临床应用效果。方法回顾性研究2019年1月—2022年5月于桂林医学院第二附属医院接受超声引导下射频消融治疗的原发性甲亢患者16(男4,女12)例,平均年龄(31.20±1.72)岁,术前甲功指标:T3(4.15±0.64)nmol/L、T4(192.3±3.2)nmol/L、TSH<0.05 uIU/mL。在术前准备期间,所有患者均口服卢戈氏液1周,术前3 d连续静脉使用地塞米松。术后1 d和3 d复查超声评估术区有无血肿,观察有无甲状腺危象发生,记录生命体征和基础代谢率变化等情况。结果16例患者均顺利完成超声引导下甲亢射频消融治疗,手术操作总时间为(32.6±6.4)min,术后无一例患者出现术区血肿、甲状腺危象、低钙血症、声音嘶哑等并发症,基础代谢率均<(+)20%。结论卢戈氏液联合地塞米松作为超声引导下射频消融治疗原发性甲亢的术前准备方法,可有效降低出血、甲亢危象等并发症的发生。

Objective To investigate the clinical effect of Lugo's solution combined with dexamethasone in preoperative preparation for radiofrequency ablation(RFA)in the treatment of primary hyperthyroidism.Methods A retrospective study was conducted on 16 patients(4 males and 12 females)with primary hyperthyroidism who received ultrasound-guided RFA in the Second Affiliated Hospital of Guilin Medical University from January 2019 to May 2022.Mean age of them was(31.20±1.72)years old.Preoperative thyroid function indicators included T3(4.15±0.64)nmol/L,T4(192.3±3.2)nmol/L,and TSH<0.05 uIU/mL.During preoperative preparation,all patients received 1 W of Lugo's solution orally and continuous intravenous dexamethasone 3 d before surgery.On the 1st and 3rd day after surgery,ultrasound was performed to assess the presence of hematoma in surgical area,the occurrence of thyroid crisis were observed,and changes in vital signs and basal metabolic rate were recorded.Results All the 16 patients successfully completed ultrasound-guided RFA for hyperthyroidism,and total operation time was(32.6±6.4)min.There were no postoperative complications such as hematoma,thyroid crisis,hypocalcemia,hoarseness,etc,and basal metabolic rates were all<(+)20%.Conclusion As a preoperative preparation method,Lugo's solution combined with dexamethasone for ultrasond-guided radiofrequency ablation in the treatment of primary hyperthyroidism can effectively reduce the occurrence of complications such as bleeding and hyperthyroidism crisis,etc.