The treatment of patients with diffuse toxic goiter depends largely on the severity of the state. The main drug for the treatment of the disease is Mercazolyl. The mechanism of its action is aimed at the oppression of the activity of the thyroid enzymes, which leads to a decrease in the rate of synthesis of thyroid hormones.
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Basic treatment schemes
Patients with severe and medigative forms of diffuse toxic goiter are subject to treatment in the hospital. Children are assigned bedding for 3-4 weeks, physiological diet with a high norm of protein and vitamins.
The main drug is mercazolyl (tablets of 5 - 10 mg), which is distinguished by an inhibitory effect on the activity of the fibroid systems enzymes, the result of which is the slowdown in the synthesis of thyroid hormones.
Mercazolyl is prescribed at the beginning of treatment in optimal doses with binding overall monitoring of the general condition and data of additional methods of examination (determining the level of iodine associated with proteins, thyroxine, triiodothyronine). The by-action of Mercazolil is manifested in the form of anemia. Reducing the dose of Mercazolyl is carried out gradually every 1 - 2 weeks before reaching a supporting dose. Supporting dose is given within 6 - 12 months. For the prevention of the disease and compensation for the shortage of thyroid hormones, which may occur when using thyretostatic drugs, from the 3rd week of treatment it is recommended to be prescribed simultaneously with Mercazolyl thyroidin in small, individually selected doses or triiodothynes by 2 to 4 weeks with a gradual cancellation of them when decreasing thyroid sizes and the achievement of the eutheroid state.
Treatment with severe forms of diffuse toxic goiter
With severe and moderate forms of thyrotoxicosis, the use of reserpine. The reserpine has a sedative and hypotensive effect, reduce heart rate, normalizes sleep. The reduction in the dose is carried out under the control of the pulse, blood pressure and is carried out within 1 - 2 months. With severe forms of the disease, small tranquilizers are prescribed (trioxazine, sadocent, elenium), with moderate forms - limited to Valerian drugs. The treatment complex uses the purpose of vitamins (A, C, B1 B2, B6, B12, B15), Cocarboxylase, calcium preparations.
Treatment of light forms of the disease
With a light form of thyrotoxicosis, treatment is carried out at home with iodine preparations by repeated courses 20 days with a break of 10 days. However, the use of iodine preparations does not always bring success in treatment and can lead to recurrence. In the absence of effect from conservative therapy for 6 - 12 months, surgical treatment is shown. After inpatient treatment, children are allowed to school after 1 - 1.5 months with exemption from physical exertion and the provision of an additional weekend.
Prevention
To prevent the development of heavy forms of thyrotoxicosis, dispensary monitoring of children with an increase in the thyroid gland without disturbing its function, especially when specifying the family nature of pathology. Important treatment and sanitation of chronic infection foci in children with increasing thyroid gland without impairment.
Late, untimely diagnosis of the disease can lead to the development of a life-threatening state - thyrotoxic crisis. Tireotoxic crisis may also occur with insufficient preliminary preparation of a patient for operational interference on the thyroid gland or other organs.
Proper treatment with many patients provides recovery. However, both a conservative and surgical treatment, thyrotoxicosis relapses are possible. The consequence of the operation may be the development of hypothyroidism, which requires substitution therapy by thyroid hormones in systematic medical supervision.
