Klementschitsch P, Shen K L, Kaplan E L
Surg Clin North Am. 1979 Feb;59(1):35-44. doi: 10.1016/s0039-6109(16)41731-7.
Hyperthyroidism of Graves' disease may be treated very effectively by antithyroid pills, such as PTU and Tapazole, by radioactive iodine therapy, and by subtotal thyroidectomy. Each form of therapy has advantages and disadvantages, and thus treatment should be individualized. While therapy with radioactive iodine would appear to be ideal since it does not require an operation and is less expensive than surgical management, it suffers from a high rate of progressive hypothyroidism and from the fact that the time until a euthyroid state is obtained is often prolonged. In addition, the long-term carcinogenic risk of the therapy for thyroid neoplasia has never been completely defined since the data most often quoted have a mean follow-up time of only eight years. Furthermore, new "low-dose" radioiodine regimens may be more dangerous in this regard. Subtotal thyroidectomy, while not totally without complications, remains a rapid, safe, and effective treatment for Graves' disease. The careful use of propranolol has facilitated the preparation of some patients and has lessened the risk of operation. Thyroidectomy should remain the treatment of choice for young adults with this disease.
格雷夫斯病的甲状腺功能亢进症可用抗甲状腺药物（如丙硫氧嘧啶和甲巯咪唑）、放射性碘治疗以及甲状腺次全切除术进行非常有效的治疗。每种治疗方式都有其优缺点，因此治疗应个体化。虽然放射性碘治疗似乎很理想，因为它无需手术且比手术治疗费用更低，但它存在甲状腺功能减退进展率高的问题，而且达到甲状腺功能正常状态所需的时间往往较长。此外，由于最常引用的数据的平均随访时间仅为八年，甲状腺肿瘤治疗的长期致癌风险从未得到完全明确。此外，新的“低剂量”放射性碘治疗方案在这方面可能更危险。甲状腺次全切除术虽然并非完全没有并发症，但仍然是治疗格雷夫斯病的快速、安全且有效的方法。谨慎使用普萘洛尔有助于一些患者的术前准备，并降低了手术风险。对于患有这种疾病的年轻人，甲状腺切除术仍应是首选治疗方法。
