心得安对甲亢患者术后甲状腺素影响的临床研究  

CLINICAL STUDY OF THE EFFECTS OF PROPRANOLOL ON POSTOPERATIVE SERUM THYROXINE IN HYPERTHYROID PATIENTS

作　　者：郭跃先[1] 王秀丽[1] 张金华[1] 张永军 高继红[3] 

机构地区：[1]河北医科大学附属第三临床医院外科 [2]河北承德市解放军266医院 [3]河北承德医学院微生物教研室

出　　处：《河北医学》1999年第9期1-4,共4页Hebei Medicine

摘　　要：目的：探讨围术期服用心得安对甲亢病人术后甲状腺激素的影响。方法：对３２例中、重度甲亢患者按手术前后是否服用心得安随机等分为四组：Ａ组：手术前后均服用心得安；Ｂ组：术前服用心得安；Ｃ组：术后服用心得安；Ｄ组：术前术后均未服用心得安。放免法测定Ｔ３、Ｔ４、ｒＴ３、ＴＳＨ的变化。结果：术后１～７ｄ各组Ｔ３值均有明显下降（Ｐ＜０．０５），而Ｃ、Ｄ组于术后１～３ｄ下降更明显（Ｐ＜０．０１）；Ｃ、Ｄ组ｒＴ３值术后１～３ｄ明显上升（Ｐ＜０．０５）。组间相比，Ｔ３于术后１～７ｄ、ｒＴ３于术后１～３ｄ，Ａ组与Ｃ、Ｄ组间均存在明显差异（Ｐ＜０．０５），而Ａ、Ｂ组间无明显差异。结论：术前应用心得安可明显抑制术后Ｔ３的急剧下降，减少甲状腺危象的发生。ABSTRACT Objective:To investigate t he effects of propranolol during perioperative treatment on thyroxine in hyperthyroid patients. Method: Thirty-two patients undergoing elective operation were randomly divided into four equal groups whether propranolol was taken during perioperative treatment.Group A:taken propranolol during perioperative treatment;group B:taken propranolol before operation;group C:taken propranolol after operation;group D:not taken propranolol during perioperative treatment.The consecutive changes of T3,T4,rT3 and TSH were monitored with radioimmunological assay.Result:The level of T3 in all groups decreased postoperative 1～7days(P <0.05);in group C & D,the level of T3 decreased significantly,particularly 1～3 days after operation(P<0.01),while significant changes of rT3 were also observed during 1～3days after operation (P<0.05).By comparing with each,the level of postoperative T3 and rT3 had significant difference between A and C group or between A and D group(P<0.05).Conclusion:propranolol used before the operation could inhibit quick decrease in postoperative T3 and lessen the rate of thyroid cyisis. KEY WORDS Propranolol; Perioperative tr eatment;Hyperthyroidism;Thyroxine

关 键 词：心得安 围术期 甲状腺机能亢进 甲状腺激素 

分 类 号：R653.05[医药卫生—外科学] R581.105[医药卫生—临床医学]