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甲状腺切除术后甲状腺毒症

Post-thyroidectomy thyrotoxicosis.

作者信息

Kalk W J, Durbach D, Kantor S, Levin J

出版信息

Lancet. 1978 Feb 11;1(8059):291-4. doi: 10.1016/s0140-6736(78)90067-3.

Abstract

94 patients with postoperative recurrent hyperthyroidism were evaluated for duration of remission, goitre size, and response to radio-iodine (131I). 6 patients required 131I therapy within twelve months of operation--5 had large remnants because of inadequate surgery. 57% of patients relapsed within 5 years, but 16% relapsed after 20 years and 8% after more than 30 years. Estimated goitre weights ranged from 4 g to 65 g, and goitre size was unrelated to the duration of remission. All patients were treated with 131I. 23% of the patients became hypothyroid in the first postoperative year and 10% in the second year. The results indicate that postoperative thyrotoxicosis can recur decades after operation. Operation seems to sensitise the thyroid to the early effects of radiation by 131I.

摘要

对94例术后复发性甲状腺功能亢进患者的缓解期、甲状腺肿大小及对放射性碘(131I)的反应进行了评估。6例患者在术后12个月内需要131I治疗,其中5例因手术不充分而残留较大甲状腺组织。57%的患者在5年内复发,但16%在20年后复发,8%在30多年后复发。估计甲状腺肿重量在4克至65克之间,甲状腺肿大小与缓解期长短无关。所有患者均接受131I治疗。23%的患者在术后第一年发生甲状腺功能减退,10%在第二年发生。结果表明,术后甲状腺毒症可在术后数十年复发。手术似乎使甲状腺对131I辐射的早期效应敏感。

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