Simms J M, Talbot C H
Br J Surg. 1983 Oct;70(10):581-3. doi: 10.1002/bjs.1800701004.
Recent reports have suggested the use of radio-iodine for the treatment of all cases of thyrotoxicosis. This paper evaluates the results of 627 patients undergoing subtotal thyroidectomy with a mean follow-up of 5 X 8 years. The most common complications were hypothyroidism (26 X 6 per cent) and recurrent thyrotoxicosis (2 X 6 per cent). Permanent hypocalcaemia occurred in 8 cases (1 X 4 per cent) and one patient developed a permanent, though asymptomatic, unilateral cord palsy (0 X 2 per cent). Ultimately all patients receiving radio-iodine appear to become hypothyroid and there is continued worry about possible thyroid malignancy. Almost 70 per cent of our cases were free of complications and euthyroid and we therefore believe that surgery remains the treatment of choice for thyrotoxicosis. We also discuss the difference in results between Graves disease and toxic multinodular goitre.
近期报告建议对所有甲状腺毒症病例采用放射性碘治疗。本文评估了627例行甲状腺次全切除术患者的结果，平均随访时间为5×8年。最常见的并发症是甲状腺功能减退（26×6%）和复发性甲状腺毒症（2×6%）。8例（1×4%）发生永久性低钙血症，1例患者出现永久性（虽无症状）单侧声带麻痹（0×2%）。最终，所有接受放射性碘治疗的患者似乎都会出现甲状腺功能减退，并且人们一直担心可能发生甲状腺恶性肿瘤。我们近70%的病例无并发症且甲状腺功能正常，因此我们认为手术仍是甲状腺毒症的首选治疗方法。我们还讨论了格雷夫斯病和毒性多结节性甲状腺肿在治疗结果上的差异。
