Schüssler-Fiorenza Chris M, Bruns Cristin M, Chen Herbert
Department of Surgery, Section of Endocrine Surgery, University of Wisconsin, Madison, 53792, USA.
J Surg Res. 2006 Jun 15;133(2):207-14. doi: 10.1016/j.jss.2005.12.014. Epub 2006 Feb 3.
The historical aspects of the pathophysiology and treatment of Graves' disease are briefly discussed in this paper.
The three treatment modalities of Graves' disease are anti-thyroid drug therapy, radioactive iodine therapy, and surgery. Although the majority of patients with Graves' disease in the U.S. are treated with radioactive iodine, surgery still plays an important role when patients cannot tolerate anti-thyroid drug therapy, when medical treatment is rejected by patients, or when surgery is deemed the fastest and safest route in managing the patient.
The indications for surgical management of Graves' disease are discussed with emphasis on available data supporting the extent of thyroid resection based on the incidences of hypothyroidism, recurrence of hyperthyroidism, recurrent laryngeal nerve injury and hypoparathyroidism.
本文简要讨论了格雷夫斯病病理生理学和治疗的历史方面。
格雷夫斯病的三种治疗方式为抗甲状腺药物治疗、放射性碘治疗和手术治疗。虽然美国大多数格雷夫斯病患者接受放射性碘治疗,但当患者不能耐受抗甲状腺药物治疗、患者拒绝药物治疗或手术被认为是治疗该患者最快且最安全的途径时,手术仍发挥着重要作用。
讨论了格雷夫斯病手术治疗的适应证,重点是基于甲状腺功能减退、甲状腺功能亢进复发、喉返神经损伤和甲状旁腺功能减退的发生率来支持甲状腺切除范围的现有数据。