| Objective:The incidence of subacute thyroiditis has gradually increased in recent years,and its etiology is unknown.The clinical manifestations of subacute thyroiditis are mainly pain in the front neck,thyroid area tenderness and thyroid enlargement;ultrasonography shows a flaky hypoechoic area in the thyroid gland,and about 30%of patients with subacute thyroiditis will occur Hypothyroidism[1-3].Traditional treatments for subacute thyroiditis include oral non-steroidal anti-inflammatory drugs,glucocorticoids,and beta-blockers.Oral non-steroidal anti-inflammatory drugs have a long treatment period and slow symptom relief.The disadvantages of oral glucocorticoids are mainly to reduce the body’s resistance to pathogenic microorganisms,induce or aggravate infection,increase appetite,peptic ulcer,adrenal insufficiency.Et al[4-5];the purpose of this study was to observe the clinical application of ultrasound-guided percutaneous intrathyroid injection of glucocorticoids（methylprednisolone,dexamethasone,compound betamethasone）in the treatment of SAT.Efficacy,evaluate its advantages and characteristics compared with traditional treatment.Methods:120 new patients with subacute thyroiditis were selected(diagnostic criteria refer to the report of Pearce EN et al.[6]).They were randomly divided into four groups:methylprednisolone 40 mg treatment group（group A）.),dexamethasone 5 mg treatment group（group B）,compound betamethasone 1 ml treatment group（group C）and oral prednisone 10 mg tid treatment group（group D）.In the four groups,groups A,B,and C were the treatment group,and group D was the control group.The efficacy and safety of the treatment were evaluated by comparing the clinical symptoms,thyroid function,inflammation index and systemic metabolism with the control group before and 24 weeks after treatment.Results:1.General conditions The age,gender,and VAS and BMI of the patients were not statistically significant（P>0.05）.2.Efficacy evaluation Compared with before treatment,the clinical symptoms of the four groups were relieved after treatment,T3,T4,FT3,FT4 decreased significantly,TSH increased significantly,and ESR and CRP decreased significantly（P<0.05）.Compared with the control group,the treatment group had shorter time spent on pain regression,and the time to resolve the symptoms of thyroid swelling was significantly shorter（P<0.05）,and the changes of TSH and CRP levels were more significant（P<0.05）.The total treatment period of the treatment group significantly less than the control group（5.57±1.30 vs.7.97±1.47,P<0.05）.The total effective rate of the treatment group was significantly increased（100%vs 93.33%,P<0.05）.3.Security analysis Compared with the control group,the 2hPG and BMI of the treatment group were not significantly changed before and after treatment（P>0.05）,while the control group had 2hPG and BMI increased after treatment（P<0.05）.There were no significant differences in FBG,TG and TC between the two groups（P>0.05）.After treatment,the levels of COR and ACTH were significantly lower in the two groups（P<0.05）.In the long-term follow-up of the two groups,there was no significant difference in blood glucose,blood lipids,body type,COR and ACTH between the treatment group and the control group（P>0.05）.The recurrence rate of the treatment group was significantly decreased 3 months after the drug was stopped（P<0.05）.Conclusion:Ultrasound-guided percutaneous intrathyroidal injection of glucocorticoid preparat ion can effectively cure subacute thyroiditis,and compared with traditional treatment of oral glucocorticoid therapy,it relieves symptoms quickly,has a short treatment period,and has little effect on systemic metabolism. |
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