甲状腺术后血清甲状腺激素水平的变化  

Changes of the level of serum thyroxine after thyroid gland operation

作　　者：洪伟力 胡成 梅海博 

机构地区：[1]浙江大学城市学院医学与生命科学学院普通外科,浙江省杭州310000

出　　处：《中国基层医药》2011年第15期2033-2034,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的了解甲状腺不同手术方式对术后甲状腺激素水平的影响，为术后替代治疗提供依据。方法对120例甲状腺腺瘤采取单纯腺瘤切除术30例，单侧腺叶切除术，30例，双侧次全切除术30例，全切除术30例，观察比较不同手术方式治疗的甲状腺手术前、手术后第10天、1个月、3个月血清甲状腺激素水平。结果单纯腺瘤切除术前后FT3、FT4水平没有变化、单侧腺叶切除术后FT3、FT4水平在第10天时出现一过性降低（P〈0．01）；双侧次全切除术后第10天及1个月FT3、FT4均低于术前水平（P〈0．01），3个月后恢复到术前水平；全切术后患者口服甲状腺素片维持，甲状腺激素水平与术前差异无统计学意义。结论甲状腺单侧腺叶切除，双侧次全切除及全切均会不同程度的在某一时间段引起甲状腺激素水平降低，需要给予适当的替代治疗。Objeetive To investigate changes of the level of serum thyroxine after different style operation on thyroid gland,for guiding replacement therapy after surgery. Methods To select patients randomly,include the excision of adenoma of thyroid,the lobectomy of unilateral thyroid,the subtotal ectomy of bilateral thyroid and total resection of bilateral thyroid quaque forty, among the total, the patients who suffererd the total resection of bilateral thyroid take thyroxine 40mg bid orally everyday. To detect the serum thyroxine in all of the patients, when preoperation,ten days after operation,one month after operation and three months after operation. Results The serum thyroxine in patients who suffererd the excision of adenoma of thyroid were had no marked changes compare to preoperation; Serum FT3 ,FT4 in patients suffer the lobectomy of unilateral thyroid are lower than preoperation when ten days after operation （P 〈0. 01 ）;Serum FT3 ,FT4 in patients sufferred subtotal ectomy of bilateral thyroid were lower than preoperation, when ten days after operation and one month after operation （ P 〈 0.01 ）, then returned to the level of preoperation when three months after operation; the serum thyroxine of patients who sufferred the total resection of bilateral thyroid had no marked changes compare to preoperation,when they taker thyroxine 40mg bid orally everyday. Conclusion The Serum thyroxine level of patients who suffer the lobectomy of unilateral thyroid, the subtotal ectomy of bilateral thyroid and total resection of bilateral thyroid is lower than preoperation at different degree, they should be given replacement therapy properly.

关 键 词：甲状腺肿瘤 甲状激素 手术后并发症 

分 类 号：R73[医药卫生—肿瘤]