甲状腺动脉栓塞治疗Graves病

目的探讨甲状腺动脉栓塞治疗难治性Graves病的临床应用。方法30例难治性Graves病患者经超选择插管至甲状腺上、下动脉造影，根据动脉管径选择不同直径的聚乙烯醇分步栓塞，并用钢圈加强。栓塞体积达80％以上。结果30例患者栓塞术均成功。栓塞2周后，临床症状消失，甲状腺体积缩小，4周后甲状腺功能正常。随访24～40个月，26例临床治愈，无甲状腺功能减低或甲状旁腺功能减低，突眼无加重。4例复发，其中3例服抗甲状腺药物治疗，1例手术治疗。结论介入栓塞甲状腺上、下动脉治疗难治性Graves病简单、安全、疗效显著，为Graves病的治疗提供了一种有效的新方法。

Thyroid gland arterial embolization in the treatment of Graves disease

Objective To study the clinical effects and safety of thyroid gland arterial embolization in the treatment of refractory Graves disease.Methods Superselective arteriography and interventional embolization of thyroid superior and inferior arteries were performed by polyvinyl alcohol with different particles according to the diameters of branchs in 30 patients with refractory Graves disease.Steel coil was added to enhance the embolization effect.The embolization volume was mroe than 80% of thyroid gland.Results The procedures were succeeded in all patients.Symptoms became remission and the size of thyroid glands decreased significantly after 2 weeks of embolization.The thyroid glands decreased significantly after 2 weeks of embolization.The thyroid function gradually returned to normal level after 4 weeks.Followed up by 24~40 months,36 cases remained in euthyroid state without hypothyroidism or hypoparathyroidism,no aggravation of ophthalmopathy occurred.Four cases recurred and were treated with antithyroid drug therapy in 3 case,the other cured by thyroidectomy.Conclusion The technique of embolization of superior and inferior thyroid arteries is a safe,convenient and effective therapy for refractory Graves disease.