甲狀腺高能症與其相關的手術治療

10.6666/ClinMed.2017.79.3.026

陳瑞裕；李建賢；曾令民

甲狀腺高能症(hyperthyroidism) ； 葛瑞夫茲氏症(Graves' disease) ； 甲狀腺切除手術(thyroidectomy)

臨床醫學月刊

79卷3期（2017 / 03 / 31）

141 - 148

繁體中文

甲狀腺高能症(hyperthyroidism)是相當常見的疾病，在女性的發生率比男性為多。甲狀腺的過度分泌甲狀腺賀爾蒙，在臨床上會造成病人有體重減輕、心悸、顫抖、怕熱等現象。甲狀腺高能症的發生原因有很多，最常見的為葛瑞夫茲氏症(Graves'disease)，它除了甲狀腺機能亢進的症狀與甲狀腺腫大外，還會伴隨凸眼的困擾。在血中生化檢查評估上，甲狀腺機能亢進時，游離四碘甲狀腺素(Free T4)升高而壓抑了甲促素(TSH)的分泌。甲狀腺高能症的治療，可以使用抗甲狀腺藥物治療，放射線碘治療，與外科手術治療。隨著醫療的進步，喉返神經偵測系統與高頻能量手術器械(energy device)的應用，已為甲狀腺手術帶來相當的好處，並減少手術可能的相關併發症。而現代手術的發展，利用內視鏡與機械手臂系統輔助甲狀腺手術，雖由於甲狀腺高能症患者常伴隨有較大的甲狀腺而有所侷限，不過在少數病患上，可以是手術治療的選擇。

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