碘剂在甲亢围手术期应用的临床对比性研究  

Clinical Research on the Perioperative Application of Iodides in Patients with Hyperthyroidism

作　　者：乔文礼[1] 满都胡[2] 张瑞明[1] 张彤[1] 宝力道[1] 

机构地区：[1]内蒙古医学院附属医院普外科 [2]内蒙古民族大学附属医院蒙医外科

出　　处：《内蒙古医学杂志》2009年第4期389-392,共4页Inner Mongolia Medical Journal

基　　金：内蒙古自治区自然科学基金项目(20010906-18)

摘　　要：目的:探讨甲状腺机能亢进症(甲亢)围手术期术后服碘或不服碘对病人体内甲状腺素和皮质醇的影响。方法:对60例中、重度甲亢病人按术后是否服碘随机分为A、B两组,术后服碘A组30例,术后不服碘B组30例,60例病人均经内科门诊口服抗甲状腺药物治疗3个月以上,转外科。用放射免疫法测定手术前后不同时间的T3、T4、促甲状腺激素(TSH)及皮质醇的变化。结果:全部病例病情均稳定控制,甲状腺缩小变硬,如期手术,无危象及呼吸道并发症发生。T3、T4、TSH服碘前和术晨比较差异无统计学意义,术后24、36 h下降明显(P<0.01);A、B两组组间比较差异无统计学意义;皮质醇两组术晨、术后与服碘前比较呈下降趋势(P<0.01),术后24 h与36 h结果比较差异无统计学意义。结论:术前服碘是甲亢术前准备用药中重要、安全、可靠的方法。术后服碘已无实际意义。Objective：To investigate the effects of iodides on thyroid hormone and hydrocortisone with hyperthyroidism before and after operation . Methods： 60 patients with mediate or severe degree hyperthyroidism undergoing operation were randomly divided into A or B two groups according to whether to take iodides after operation. Group A： 30 cases taken iodides after operation . Group B： 30 cases not taking iodides after operation. All the patients had been treated more than one month by medicine to take antithyroid hormone. The consecutive change of T3, T4, TSH and Hydrocortisone were measured with radioimmunological assay preand post operatively. Results： All the cases were controlled. The level of T3, T4, TSH in two groups decreased post operative morning to 36 hours（P （0.01）. By comparing with operation morning and before take iodides, the level of T3, T4 and TSH had significant difference between group A and B. By comparing with operation morning and before take iodides, the level of hydrocortisone decreased significantly （P〈0.01）.By comparing with operation morning and before take iodides, the level of hydrocortisone had significant difference between after 24 h and 36 h. Conclusions： Iodides used before the operation is the most methods of security and reliability. It has not significance to take iodides after operation.

关 键 词：碘剂 甲状腺机能亢进症 围手术期 皮质醇 甲状腺危象 

分 类 号：R581.1[医药卫生—内分泌]