Ultrasound Guided Local Injection Of Dexamethasone Sodium Phosphate In The Treatment Of Subacute Thyroiditis

Objective: Subacute thyroiditis is one of the most common thyroid pain diseases.Most patients come to see a doctor with neck discomfort,pain,chills and fever,and fatigue.Traditional NSAIDs are usually treated with NSAIDs or oral glucocorticoids,but oral NSAIDs have the disadvantages of slow symptom relief and long medication time.Oral glucocorticoids have the disadvantages of large adverse reactions and easy induction The infection was aggravated.In this study,ultrasound-guided local injection of dexamethasone sodium phosphate was used to treat subacute thyroiditis.Methods: From July 2019 to July 2020,50 patients with subacute thyroiditis who came to our hospital for diagnosis due to low fever,neck pain and discomfort were randomly divided into two groups according to different treatment methods.Among them,25 cases in the oral drug treatment group were treated with prednisone,20-40 mg /d,but the maximum daily dose was less than 60 mg /d.after 1-2 weeks of maintenance treatment,the dosage was reduced after the symptoms were controlled,the maintenance dose was about 5-10 mg /d,and the course of treatment was about 6-8 weeks.In the ultrasound-guided local thyroid injection group,25 cases were injected with 1-1.5ml dexamethasone sodium phosphate injection in the hypoechoic area of the affected lateral lobe of the thyroid under the guidance of ultrasound,once a week,and the total course of treatment was about 6-8 weeks.Color Doppler ultrasound and related biochemical indexes were reviewed every 2 weeks.Results:(1)The total effective rate of the local injection treatment group was 96%,higher than that of the oral drug treatment group(76%),and the recurrence rate was 4% after 3 months,which was lower than that of the oral drug treatment group(24%),the difference was statistically significant(P < 0.05).(2)the average disappearance time of local thyroid pain,low fever and other symptoms in the local injection treatment group was(5.2 ± 2.1)days,and the recovery time of thyroid function was(9.2 ± 3.5)days were shorter than(7.3 ± 3.2)days and(11.2 ± 2.7)days in the oral medication group,and the difference was statistically significant(P< 0.05).(3)before treatment,the average ESR count level in the local treatment group was(57.00 ± 17.913 mm / H),but there was no significant difference between the two groups(58 ± 18.103 mm / H)(P > 0.05);after 2 weeks and 4 weeks of treatment,local injection was used The ESR of the two groups was(35.00 ± 9.384 mm / H,25.00 ± 10.286 mm / H),and the difference was statistically significant(P< 0.05)compared with the oral drug treatment group(49.00 ± 11.278 mm /H,39.00 ± 12.458 mm / H)(P < 0.05).After 8 weeks of treatment,the average level of ESR in peripheral blood of the two groups was close to normal,and there was no significant difference between the two groups(P> 0.05).(4)the level of CRP in the local treatment group before treatment was flat The average count level was(46.53 ± 25.399 mg / L),which had no statistical significance compared with the oral drug treatment group(45.20 ± 20.566 mg / L)(P> 0.05);after 2 weeks and 4 weeks of treatment,the peripheral blood CRP of the local injection treatment group was(26.23 ± 10.651 mg / L,18.70 ± 5.708 mg / L),compared with the oral drug treatment group(35.22 ± 11.532 mg / L,22.65 ± 7.253 mg / L)After 8 weeks of treatment,the average level of CRP in peripheral blood of the two groups was close to normal,and there was no significant difference between the two groups(P> 0.05).(5)the average times of medication in the local injection treatment group was(6.2±2.4)times,and that in the oral drug treatment group was(35.2±10.4)times,the difference was statistically significant(P< 0.05);(6)the local injection treatment group had 2Patients(8%)had different degrees of adverse reactions,compared with the oral drug treatment group(8 cases,32%),the difference was statistically significant(P< 0.05).Conclusion: Ultrasound guided local injection of songdexamethasone sodium phosphate in the treatment of subacute thyroiditis is rapid,safe and effective,with low recurrence rate and few adverse reactions.