Zieleźnik W, Sieroń A, Peszel-Barlik M, Zieleźnik M, Simon-Sieroń M
III Katedry i Kliniki Chorób Wewnetrznych Slaskiej Akademii Medycznej w Katowicach.
Wiad Lek. 1997;50(7-9):211-6.
The introduction of new diagnostic methods for the evaluation of solitary thyroid nodules allows for unquestionable differentiation between malignant and benign lesions in most cases. It makes therapeutic procedure other than surgical therapy possible. One of the procedures is the percutaneous alcohol sclerotherapy (PSA). It is the most commonly used for the treatment of thyroid cysts and autonomous thyroid nodules. PSA was first proposed by Livraghi in 1990 as possible therapy for autonomously functioning thyroid nodules. This method is based on the administration of a limited amount of sterile alcohol into the thyroid nodule under direct ultrasonografic control. The application of PSA according to the worked out procedure gives a permanent remission of thyroid cysts in most cases and the 85-100% decrease of thyroid nodule volume. In the case of "toxic" and "pretoxic" type of nodules, a normalization of serum FT3, FT4 and TSH level occurs. Scintigraphy shows recovery of extranodular uptake of radionuclide and effacement of previously hot area of thyroid scintiscan. The following complications were observed after PSA: pain of the injection site, local hematoma, fever, sinus tachycardia, transient dysphonia. The intensity of these complications is generally low.
用于评估甲状腺孤立结节的新诊断方法的引入,在大多数情况下能够明确区分恶性和良性病变。这使得非手术治疗成为可能。其中一种治疗方法是经皮酒精硬化疗法(PSA)。它是治疗甲状腺囊肿和自主性甲状腺结节最常用的方法。PSA于1990年由利夫拉吉首次提出,作为自主性功能性甲状腺结节的一种可能治疗方法。该方法是在直接超声控制下,向甲状腺结节内注射有限量的无菌酒精。按照既定程序应用PSA,在大多数情况下可使甲状腺囊肿永久缓解,甲状腺结节体积缩小85% - 100%。对于“毒性”和“亚毒性”类型的结节,血清FT3、FT4和TSH水平可恢复正常。闪烁扫描显示甲状腺结节外放射性核素摄取恢复,甲状腺闪烁扫描先前的热区消失。PSA治疗后观察到以下并发症:注射部位疼痛、局部血肿、发热、窦性心动过速、短暂性发音困难。这些并发症的严重程度一般较低。