全甲状腺切除术治疗年轻女性严重甲状腺中毒：病例报告
Total Thyroidectomy for Severe Thyrotoxicosis in a Young Woman: A Case Report.
摘要(中文译文)
Graves病是自身免疫性甲状腺功能亢进症最常见的病因，通常采用抗甲状腺药物、放射性碘或手术治疗。然而，部分患者会出现持续性甲状腺毒症或需要确定性治疗的严重并发症。我们报告一例23岁女性Graves病合并1型糖尿病患者，尽管长期接受甲巯咪唑和β受体阻滞剂治疗，仍表现为持续性甲状腺毒症，既往有糖尿病酮症酸中毒并发甲状腺危象的病史。体格检查显示弥漫性III度甲状腺肿，伴有甲状腺功能亢进的临床特征，实验室检查显示促甲状腺激素受抑制，游离甲状腺激素水平显著升高。影像学显示弥漫性甲状腺肿大伴血供增加及轻度气管受压。经多学科评估后，患者接受了全甲状腺切除术，术后经过顺利，组织病理学证实为弥漫性增生性甲状腺肿伴慢性甲状腺炎。本病例凸显了全甲状腺切除术作为难治性甲状腺毒症安全有效的确定性治疗方法，并提示早期手术干预可能预防危及生命的并发症，如甲状腺危象，尤其是在合并复杂代谢性共病的患者中。
Abstract
Graves' disease is the most common cause of autoimmune hyperthyroidism and is typically managed with antithyroid medications, radioactive iodine, or surgery. However, a subset of patients develops persistent thyrotoxicosis or severe complications requiring definitive treatment. We report the case of a 23-year-old woman with Graves' disease and type 1 diabetes mellitus who presented with persistent thyrotoxicosis despite prolonged treatment with methimazole and beta-blockers, with a prior history of diabetic ketoacidosis complicated by thyroid storm. Physical examination revealed a diffuse grade III goiter with clinical features of hyperthyroidism, while laboratory tests showed suppressed thyroid-stimulating hormone and markedly elevated free thyroid hormone levels. Imaging demonstrated diffuse thyroid enlargement with increased vascularity and mild tracheal compression. Following multidisciplinary evaluation, the patient underwent total thyroidectomy with an uneventful postoperative course, and histopathology confirmed diffuse hyperplastic goiter with chronic thyroiditis. This case highlights total thyroidectomy as a safe and effective definitive treatment for refractory thyrotoxicosis, and suggests that early surgical intervention may prevent life-threatening complications, such as thyroid storm, particularly in patients with complex metabolic comorbidities.
如何引用
AMA
Hugo E Mora Moreno, Ulises S Sánchez Guevara, Maria G Maciel García, César A Durán Ramírez, Bryan G Vasquez Marta. Total Thyroidectomy for Severe Thyrotoxicosis in a Young Woman: A Case Report.. Cureus. 2026; doi:10.7759/cureus.107104.
APA
Hugo E Mora Moreno, Ulises S Sánchez Guevara, Maria G Maciel García, César A Durán Ramírez, Bryan G Vasquez Marta (2026). Total Thyroidectomy for Severe Thyrotoxicosis in a Young Woman: A Case Report.. Cureus. https://doi.org/10.7759/cureus.107104
GB/T 7714
Hugo E Mora Moreno, Ulises S Sánchez Guevara, Maria G Maciel García, César A Durán Ramírez, Bryan G Vasquez Marta. Total Thyroidectomy for Severe Thyrotoxicosis in a Young Woman: A Case Report.[J]. Cureus, 2026 doi:10.7759/cureus.107104.
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