TREATMENT STRATEGY OF INTOLERANCE TO THYROID-STIMULATING DRUGS IN PATIENTS WITH GRAVES DISEASE

Abstract

Introduction. The development of methods for the effective treatment of patients with Graves' disease (diffuse toxic goiter) with intolerance to thyroid-stimulating drugs remains one of the most difficult problems in endocrinology and endocrine surgery. The issues of early diagnosis, tactics and volume of complex preoperative care and timing of the operation remain topical. Material and methods. From 2011 to 2020 in the departments of surgery of Republican Clinical Hospital 487 patients with Graves' disease were operated on. Among them were 69 (14.2%) patients with intolerance to thyroid-stimulating drugs, which were preoperatively prepared in the endocrinology department. Data analysis was carried out using the OriginPro 2015 program. During the statistical processing of the analyzed data, percentage indicators, average values, standard deviations, medians, values of the first and third quartiles were calculated. The normality of distribution was assessed using the Shapiro-Wilk test, the significance of differences between groups was assessed using the Mann-Whitney U-test. Results and discussion. After multicomponent conservative management, all 69 patients were operated on. In the early postoperative period, 1 (1.45%) death was observed due to the development of pulmonary embolism. Conclusion. The choice of methods of adequate conservative therapy and the timely performing of radical surgical intervention promote good results of treatment of patients with Graves' disease with intolerance to thyroid-stimulating drugs.