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[Graves病手术治疗后早期复发的危险因素]

[Risk factors of early recurrence after surgical treatment in Graves disease].

作者信息

Kostka Andrzej

机构信息

III Katedra Chirurgii Ogólnej, Collegium Medicum Uniwersytetu Jagiellońskiego.

出版信息

Folia Med Cracov. 2004;45(1-2):97-119.

Abstract

To determine the factors causing early recurrence after surgery for Graves disease, I've studied 81 patients who underwent subtotal thyroidectomy. Thyroid functional status was evaluated biochemically every 3 months. After one year the patients were divided into 3 categories: recurrent hyperthyroidism, euthyroidism and hypothyroidism. The following factors were analyzed: personal, environmental, antithyroid drug tolerance, indication for surgery, clinical investigation, TRAb serum titer, quality of surgical treatment, pathological findings. Prognostic factors for failure were identified by using logistic regression. The incidence of early hyperthyroidism was 11.1%. Significant factors for recurrence were goitre size <65 ml, blood group "O", positive TRAb titer, tiamazole intolerance, advanced exophthalmos and pregnancy for women. Basing on these factors "the risk scale" was created. It seems to be helpful for qualifying the selected high risk cases to primary total thyroidectomy.

摘要

为了确定Graves病手术后早期复发的原因,我研究了81例行甲状腺次全切除术的患者。每3个月通过生化检查评估甲状腺功能状态。一年后,将患者分为3类:复发性甲亢、甲状腺功能正常和甲状腺功能减退。分析了以下因素:个人因素、环境因素、抗甲状腺药物耐受性、手术指征、临床检查、TRAb血清滴度、手术治疗质量、病理结果。采用逻辑回归确定失败的预后因素。早期甲亢的发生率为11.1%。复发的显著因素包括甲状腺肿大小<65 ml、血型为“O”、TRAb滴度阳性、甲巯咪唑不耐受、重度突眼以及女性妊娠。基于这些因素创建了“风险量表”。它似乎有助于将选定的高风险病例判定为原发性甲状腺全切除术。

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