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目的:探讨左甲状腺素联合甲硫咪唑治疗儿童甲状腺功能亢进的疗效,并对其安全性进行分析。方法:选取2012年6月至2014年6月儿童甲状腺功能亢进门诊患者86例,按照随即数字表法分为观察组46例和对照组40例。观察组采用左甲状腺素与甲硫咪唑联合用药的治疗方案,对照组采用甲硫咪唑单一用药治疗方案,严密监测两组患者的体征状态,根据病情进展调节用药剂量,比较两组的治疗疗效;对不良反应作详尽记录,实施针对性的护理干预,确保治疗安全性,并于治疗2、6、12个月对两组患者的甲状腺功能指标游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、促甲状腺素(TSH)及甲状腺体积的变化进行比较。结果:治疗2个月两组的FT_3、FT_4、TSH显著改善(P<0.05),甲状腺肿体积无显著变化(P>0.05);治疗6个月两组患者甲状腺体积显著减小,观察组消肿效果更明显(P<0.05);治疗12个月观察组治疗总有效率显著高于对照组(P<0.05),皮疹、白细胞减少等不良反应发生率明显降低(P<0.05)。结论:左甲状腺素联合甲硫咪唑用于治疗儿童甲状腺素亢进的临床疗效确切,并发症显著减少,适合临床推广应用。
Objective: To investigate the efficacy of levothyroxine combined with methimazole in the treatment of hyperthyroidism in children and to analyze its safety. Methods: Totally 86 outpatients with hyperthyroidism from June 2012 to June 2014 were randomly divided into observation group (46 cases) and control group (40 cases). In the observation group, the combination regimen of levothyroxine and methimazole was used. In the control group, the single drug regimen of methimazole was used to monitor the signs and symptoms of the two groups closely. The dosage was adjusted according to the disease progression, and the curative effect was compared between the two groups. A detailed record of adverse reactions, the implementation of targeted nursing intervention to ensure the safety of treatment, and in the treatment of 2, 6, 12 months of thyroid function indicators of free triiodothyronine (FT_3), free thyroid (FT_4), thyrotropin (TSH) and thyroid volume changes were compared. Results: The FT_3, FT_4 and TSH of the two groups were significantly improved (P <0.05) and the volume of goiter did not change significantly (P> 0.05) after 2 months of treatment. The volume of thyroid gland in both groups was significantly decreased after 6 months treatment, (P <0.05). The total effective rate of the observation group was significantly higher than that of the control group (P <0.05). The incidence of skin rash and leukopenia and other adverse reactions were significantly decreased (P <0.05). Conclusion: The clinical efficacy of levothyroxine combined with methimazole for the treatment of hyperthyroidism in children is definite and the complication is significantly reduced. It is suitable for clinical application.