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超声引导下甲状腺囊内注射地塞米松与利多卡因混合液治疗亚急性甲状腺炎:一项单中心研究

Ultrasound-Guided Capsular Thyroid Injection Therapy With Dexamethasone and Lidocaine Mixture for Subacute Thyroiditis: A Single-Center Study.

作者信息

Huo Jinlong, Chen Chen, Gao Dan, Yang Li, Qu Rui, Jiang Hang, Chen Xin, Guo Youming, Zhu Shuanghong, Ou Dong, Zhao Lijin

机构信息

Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, China.

Department of Breast and Thyroid Surgery, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi), Zunyi, China.

出版信息

J Ultrasound Med. 2023 Feb;42(3):613-621. doi: 10.1002/jum.16054. Epub 2022 Sep 3.

Abstract

OBJECTIVES

Subacute thyroiditis (SAT) is a self-limiting, inflammatory thyroid disease possibly caused by viral infection. In recent years, the incidence of SAT is increasing, especially during the pandemic of the COVID-19. This study aimed to evaluate the efficacy, safety, and recovery time of capsular thyroid injection therapy under ultrasound guidance for SAT.

METHODS

A total of 73 patients with SAT were divided into two groups. Patients in group A (n = 48) received an ultrasound-guided capsular injection consisting of dexamethasone (DEX) and lidocaine in the thyroid lesion area, while patients in group B (n = 25) received oral prednisolone (PSL). The two groups were compared for pain relief and treatment duration, the recovery time of thyroid function, recurrence rates, hypothyroidism incidence, and drug-related side effects.

RESULTS

The follow-up time was 1 year. In group A, the duration of pain relief, treatment, and recovery time of thyroid function were significantly shorter than that in group B (P < .05), and no statistically significant differences in recurrence rate or incidence of hypothyroidism were observed (P > .05). Weight gain was significantly higher in group A at the end of treatment (P < .001).

CONCLUSIONS

Compared with oral PSL treatment, ultrasound-guided local injection of DEX and lidocaine into the capsular thyroid is a safe and effective procedure that can significantly reduce the treatment time of SAT.

摘要

目的

亚急性甲状腺炎(SAT)是一种自限性炎症性甲状腺疾病,可能由病毒感染引起。近年来,SAT的发病率在上升,尤其是在新冠疫情期间。本研究旨在评估超声引导下甲状腺囊内注射治疗SAT的疗效、安全性及恢复时间。

方法

73例SAT患者分为两组。A组(n = 48)在甲状腺病变区域接受超声引导下囊内注射,注射药物为地塞米松(DEX)和利多卡因,而B组(n = 25)口服泼尼松龙(PSL)。比较两组的疼痛缓解情况、治疗持续时间、甲状腺功能恢复时间、复发率、甲状腺功能减退发生率及药物相关副作用。

结果

随访时间为1年。A组的疼痛缓解持续时间、治疗持续时间及甲状腺功能恢复时间均显著短于B组(P < 0.05),复发率及甲状腺功能减退发生率未见统计学显著差异(P > 0.05)。治疗结束时A组体重增加显著更高(P < 0.001)。

结论

与口服PSL治疗相比,超声引导下向甲状腺囊内局部注射DEX和利多卡因是一种安全有效的方法,可显著缩短SAT的治疗时间。

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