论文下载：结节性甲状腺肿手术围术期甲状腺激素变化的研究

结节性甲状腺肿手术围术期甲状腺激素变化的研究

http://www.100md.com 2011年2月5日林华赋周毅程芳

第1页

    参见附件(2390KB，2页)。

     【摘要】目的探讨结节性甲状腺肿手术对甲状腺激素的影响。方法选取结节性甲状腺肿患者30例,术前、术中和术后测量甲状腺激素FT3,FT4,T3,T4，TSH，比较术前和术中，术前和术后以及术中和术后甲状腺激素的变化。结果术前FT3,FT4,T3,T4与术中比较，差异有统计学意义(P<0.05)，术前FT3,FT4,T3与术后比较，差异有统计学意义(P<0.05),T4变化差异无统计学意义，术中与术后比较，FT3显著下降，FT4显著升高，差异有统计学意义(P<0.05)，TSH术前，术中，术后变化差异无统计学意义。结论甲状腺手术能引起甲状腺素发生变化，其变化情况可能对预后有一定指导作用。

    【关键词】结节性甲状腺肿；手术；围术期；甲状腺激素

    The research of the thyroid gland hormone changes by nodular golter surgical operation during perioperative period

    Lin Hua-fu,Zhou Yi,Cheng Fang.Clinic Operation Center,The Central Hospital of Jiangmen, Guangdong 529089,China

    

    【Abstract】 Objective To explore the effect of the surgical operation on the thyroid gland hormone .Methods The method selects 30 patients who had nodular golter . Before the operation, during the operation and after the operation measured the thyroid gland hormone FT3, FT4, T3,T4 ,TSH. Thyroid gland hormone were compared during perioperative period.Results FT3, FT4, T3,T4 were compared before opreration and during operation, there was significant difference (P<0.05).FT3, FT4, T3 compared before opreration and after operation, there was significant difference (P<0.05), T4 varietieses had never statisticsed to learn difference. Compared with during opreration and after operation as a result, the FT3 descended significantly and the FT4 heated up(p<0.05). TSH had never statisticsed to learn difference.Conclusion The thyroid gland surgical operation can result in the changes of thyroid gland hormone, it's the variety circumstance might definitely guide a function towards prognosis.

    【Key words】

    Nodular golter;Operation; Perioperative period;Thyroid hormone

    

    甲状腺手术是治疗结节性甲状腺肿的常用手段，手术切除范围以及手术操作对甲状腺激素会产生影响，了解围术期甲状腺激素的变化对指导患者术后甲状腺功能的恢复有一定的帮助，本院自2009年9月至2010年1月对甲状腺手术患者术前、术中及术后甲状腺激素进行比较，现报告如下。

    1 资料与方法

    1.1 一般资料选取30例结节性甲状腺肿患者，其中男12例，女18例，年龄最小21岁，最大78岁，平均43.74岁，行双侧次全切除术20例，单侧次全切除术10例，全部患者行双侧甲状腺次全切除术，术前诊断与术后病理相符。

    1.2 方法所选患者均采用气管内插管全身麻醉方式，术式方式选择单侧次全切除术或双侧次全切除术，取胸骨切迹上方两横指切口，游离颈前皮瓣，暴露甲状腺，探查甲状腺，处理甲状腺上极，中静脉以及下极，于甲状腺包膜内楔形切除大部分甲状腺组织，保留甲状腺外侧及后被膜，切除椎状叶。患者于术前48 h、术中(甲状腺切除后抽血)及术后48 h抽血测量甲状腺激素。

    1.3 观察指标甲状腺激素：FT3(游离三碘甲状腺原氨酸),FT4(游离甲状腺原氨酸),T3(三碘甲状腺原氨酸),T4(总甲状腺素)，TSH(促甲状腺素)。

    1.4 统计学方法采用SPSS11.5软件包进行统计分析，计量资料用均值±标准差(x±s)表示，统计学处理采用t检验。P<0.05为差异有统计学意义。

    2 结果

    2.1 术前，术中和术后FT3,FT4,T3,T4，TSH都在正常范围内。

    2.2 术前与术中比较，FT3,T3,T4，显著下降，FT4显著升高,差异有统计学意义(P<0.05)，见表1。

    2.3 术前与术后比较，FT3,FT4,T3显著下降，差异有统计学意义(P<0.05)，见表1。

    2.4 术中与术后比较，FT3显著下降 ......

http://www.100md.com/html/paper/1673-7555/2011/04/25.htm

您现在查看是摘要介绍页，详见PDF附件(2390KB，2页)。