围术期免服碘剂在甲状腺功能亢进症患者中的应用  

Application of perioperative iodine-free administration in patients with hyperthyroidism

作　　者：徐智慧 胡欢 XU Zhi-hui;HU Huan(Department of Gastroenterology,CITIC Huizhou Hospital,Guangdong Province,Huizhou516006,China)

机构地区：[1]中信惠州医院消化科,广东惠州516006

出　　处：《中国当代医药》2020年第10期87-89,93,共4页China Modern Medicine

摘　　要：目的探讨围术期免服碘剂在甲状腺功能亢进症患者中的应用效果。方法选取2014年10月~2017年12月我院收治的78例甲状腺功能亢进症患者作为研究对象,按照随机数字表方法分为对照组(n=39)和观察组(n=39)。对照组采用围术期口服碘剂的方法,观察组采用围术期免服碘剂的方法。比较两组患者的相关手术指标、治疗前后的血清游离三碘甲腺原氨酸(FT3)以及血清游离甲状腺素(FT4)水平、治疗后并发症的发生情况。结果两组的术中出血量、手术时间比较,差异无统计学意义(P>0.05),观察组治疗后的住院时间短于对照组,差异有统计学意义(P<0.05);经治疗后,两组患者FT3、FT4水平比较,差异无统计学意义(P>0.05)。经治疗后,观察组患者声嘶、暂时性甲状旁腺损伤以及甲状腺功能减退症状的发生率低于对照组,差异有统计学意义(P<0.05)。两组患者治疗前甲状腺过氧化物酶抗体(TPOAb)以及甲状腺球蛋白抗体(TGAb)比较,差异无统计学意义(P>0.05);经治疗后,观察组患者TPOAb以及TGAb低于对照组,差异有统计学意义(P<0.05)。结论甲状腺功能亢进症患者围术期免口服碘剂是可行的,其常规指标没有明显变化,且并发症得到了减少,值得推广应用。Objective To explore the application effect of perioperative iodine-free administration in patients with hyperthyroidism. Methods A total of 78 patients with hyperthyroidism who were treated in our hospital from October 2014 to December 2017 were selected as the research subjects. They were divided into the control group(n=39) and the observation group(n=39) according to the random number table method. In the control group, oral administration of iodine during perioperative period was used, and in the observation group, perioperative iodine-free was adopted. The related surgical indicators, serum free triiodothyronine(FT3) and serum free thyroxine(FT4) levels before and after treatment,incidence of complications after treatment was compared between the two groups. Results There were no significant differences in intraoperative blood loss or operation time between the two groups(P>0.05). The hospital stay in the observation group after treatment was shorter than that in the control group, and the difference was statistically significant(P<0.05). There were no significant differences in FT3 or FT4 level between the two groups after treatment(P>0.05). After treatment, the symptoms of hoarseness, temporary parathyroid injury, and hypothyroidism in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). There were no significant differences in the levels of thyroid peroxidase antibody(TPOAb) or thyroglobulin antibody(TGAb) before treatment in the two groups(P>0.05). After treatment, the TPOAb and TGAb indicators in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). Conclusion Perioperative iodine-free administration in patients with hyperthyroidism is feasible, and its routine indicators have not changed significantly, and complications have been reduced, which is worthy of promotion and application.

关 键 词：甲状腺功能亢进症 围术期 术后并发症 碘剂 

分 类 号：R587.1[医药卫生—内分泌]