甲状腺动脉栓塞治疗Graves病的不良反应与并发症分析

Analysis of adverse reactions and complications of Graves' disease after thyroid arteries embolization

目的 回顾分析甲状腺动脉栓塞术治疗Graves病的不良反应与并发症。方法 4 1例Graves病患者接受了双侧甲状腺上动脉或加一侧下动脉的栓塞治疗 ,栓塞剂选用白芨微球或聚乙烯醇微球 (PVA)和羊毛微钢圈 ,对所有患者进行了术中及术后不良反应和并发症的分析。结果 所有病例均出现不同程度的咽喉部疼痛和颈前区不适 ,栓塞术后 3d至 1周T3 、T4可有一过性增高 ,随后逐步下降至正常水平。大多数患者 (30 / 4 1)术后出现发热。 1例 (1/ 4 1)出现左侧视力部分缺失。 1例由于栓塞甲状腺上动脉主干的钢圈脱落异位至大脑中动脉顶后小分支 ,但未引起血管堵塞 ,没有出现任何临床症状。 1例术后出现一过性甲状旁腺功能低下。 1例选用白芨微球栓塞剂的患者术后出现肝功能损害。所有患者术后眼症均无变化 ,未出现声音嘶哑或发音困难 ,无并发甲状腺功能低下和甲亢危象等并发症。结论 甲状腺动脉栓塞治疗Graves病可出现一些可逆的不良反应和严重并发症 ,但通过细心操作 ,经验积累 。

Objective To retrospectively analyse the adverse reactions and complications of Graves' disease after thyroid arteries embolization.Methods 41 patients of Graves' disease underwent interventional embolization have been analysed with its adverse reactions and complications. Polyvinyl alcohol or bletilla microspheres and micro coils were used in these patients. Results Laryngopharyngeal and neck pain occurred in all patients. T 3 and T 4 increased in 3 days to one week after the procedure. Thirty of them showed fever. Dystopic embolism happened in two cases with one of transitory hypoparathyroidism. No hypothyroidism or hypoparathyroidism or hoarseness occur during long term follow up.Conclusions The adverse reactions and complications of Graves disease after thyroid arteries embolization may occur. Some of them are preventable and curable.