甲状腺功能亢进症围手术期服碘方法的对比性研究

Clinical research on the perioperative application iodides in patients with hyperthyroidism

目的探讨改进甲状腺功能亢进症围手术期服碘方法。方法对2010年1月至2011年12月收治的580例甲状腺功能亢进症患者资料进行回顾性分析,所有患者在门诊口服抗甲状腺亢进药物治疗控制症状后,随机分为改进组和常规组,其中改进组290例术前门诊口服碘剂,共8～11 d,术后不服碘;常规组290例以常规方法服碘剂。术后观察有无甲状腺危象的发生。结果全部病例病情稳定,甲状腺缩小、变硬,如期手术,所有患者无手术死亡,无甲状腺危象发生。结论术前门诊服碘,术后不服碘的准备方法安全、可靠,明显缩短了甲状腺功能亢进症围手术期外科治疗的时间,术后服碘无实际意义。

Objective To investigate the modified method of perioperative preparation for hyperthyroidism. Methods Clinical data of 580 patients with hyperthyroidism were retrospectively analyzed, from Jan. 2010 to Dec. 2011. Iodine was administered orally for 8 to 11 days for predigest group （n=290）, after taking anti-hyperthyroidism drugs to control symptoms prior to surgery, without postoperative iodine intake, which compared with the control group （n=290） who were given iodion in common methods. Thyroid crisis of the two groups were observed after the operation. Results The two groups were stable clinically and operated on as scheduled, with diminished and hardened thyroids, but no thyroid crisis or death in the operation. Conclusion The preparation method of out-patient iodine administration before the surgery, and no postoperative iodine intake is safe and reliable. It decreases perioperative duration in surgical treatment for hypeahyroidism obviously. Postoperative iodine administration has little practical value.