미만성 갑상선중독증(그레이브씨병)의 갑상선 아전절제술 후 갑상선 기능의 변화에 대한 연구

• 영문명: The Changes of Thyroid Function after Subtotal Thyroidectomy in Diffuse Toxic Goiter(Graves' Disease)
• 발행기관: 대한두경부종양학회
• 저자명: 송은영(Eun Young Song) 김성배(Sung Bae Kim) 김상효(Sang Hyo Kim)
• 간행물 정보: 『대한두경부종양학회지』제18권 제1호, 60~64쪽, 전체 5쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2002.05.30

영문 초록

Objectives : Three classic treatment modalities have been used to treat Graves' disease : antithyroid medication, radioiodine ablation, and subtotal thyroidectomy. Postoperative thyroid functions were studied in patients with Graves' disease treated by subtotal thyroidectomy to evaluate the superiority of surgical treatment. Materials and Methods : One hundred fourty patients of Graves' disease were analysed retrospectively in follow-up for more than three years f이.lowing subtotal thyroidectomy. Postoperative serum levels of T3, T4, TSH, TSH-R Ab, free T4, were evaluated to watch hypo- or hyperthyroidsm. Results : In the evaluation of preop- and postoperative thyroid function after three years of subtotal thyroidectomy, T3 was changed from 464.10± 196.16ng/dl to 140.41±76.56ng/dl in mean value, T4 was changed from 20.76±7.98 μg/dl to 9.54±4.02 μg/dl, TSHT3 was changed from 0.55 ±4.42 μ ulml to 4.96±7.20 μ u/ml, TSH-R Ab was changed from 41.6±28.27% to 28.7±28.79% and free T4 was changed from 4.45±2.33ng/dl to l.44±0.69ng/dl in mean value. Euthyroidism was noted in 118 patients(84.3%), overt hyperthyroidism in 6 patiens (4.3%), latent hyperthyroidism in 8 patients (5.7%), overt hypothyroidism in 2 patint (1.4%), and latent hypothyroidism in 6 patients (4.3%). Of surgical complications, permanant hypoparathyroidism was found in one patient, recurrent laryngeal nerve injury in two patients, postoprative bleeding with reoperation in two patients, and death in one patient. Conclusion : The thyroid function after subtotal thyroidectomy in diffuse toxic goiter is normal level (euthyroidism) in 84.3% and low recurrence rate of hyperthyroidism is showed with rare surgical complication. Therefore, subtotal thyroidectomy in diffuse toxic goiter is more effective and safe than RI or longterm ATD treatment, if the operation is performed by skillful surgeon.

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키워드

갑상선 그레이브씨병 갑상선 아전절제술 Thyroid Graves' disease Subtotal thyroidectomy