甲亢患者术前服碘前后甲状腺血流动力学及其相关性因素研究

发布时间：2018-01-02 09:20

本文关键词：甲亢患者术前服碘前后甲状腺血流动力学及其相关性因素研究　出处：《暨南大学》2016年硕士论文　论文类型：学位论文

【摘要】：背景本研究的目的是为了探讨甲亢患者服碘前后甲状腺血流动力学变化及其相关性因素。方法回顾性分析2015年1月-2016年1月收治的甲状腺功能亢进症患者。收集患者服碘前后甲状腺功能指标、血流动力学参数、服碘时间、手术时间、术中出血量等手术资料。对比研究服碘前后患者甲状腺功能、血流动力学参数及其之间的相关性,并进一步研究术前甲状腺功能及血流动力学情况对手术的影响。结果16例原发性甲亢组在服碘后FT4、收缩期峰值血流速度(peak systolic velocity,PSV)、舒张末期血流速度(end diastolic velocity,EDV)及内径(diameter,D)均较服碘前明显降低。服碘前FT3与PSV、EDV、D呈正相关,TSH与PSV、D呈负相关;服碘后FT3与PSV、D呈正相关。服碘时间与dFT3呈正相关,与dTSH呈负相关,与dPSV、dEDV呈正相关。手术时间及术中出血量与FT3、PSV、D呈正相关。继发性甲亢组服碘前肿物侧上动脉PSV、D均明显大于对侧上动脉;服碘后肿物侧上动脉直径D与对侧差别有统计学意义。在肿物最大径1cm的10例患者中,服碘前后甲状腺肿物侧上动脉PSV与肿物最大径的大小呈正相关;肿物最大径与手术时间、术中出血量呈正相关。结论甲状腺血流动力学可以在一定程度上反映甲状腺功能状态,作为甲状腺功能状态的一个参考指标。其参数变化可作为术前干预、评估碘剂的有效性及选择手术时机的量化指标。将术前血流动力学参数与甲状腺功能指标联合起来观察,有利于及时进行必要的术前干预措施,制定更为合理的手术方案,以确保手术的顺利及安全性。
[Abstract]:Background the purpose of this study was to investigate the changes of thyroid hemodynamics and its related factors in patients with hyperthyroidism before and after iodine administration. Methods retrospective analysis of thyroid hyperthyroidism admitted from January 2015 to January 2016. The thyroid function indexes were collected before and after iodine administration. Hemodynamic parameters, iodine administration time, operative time, intraoperative blood loss and other surgical data. The thyroid function, hemodynamic parameters and their correlation before and after iodine administration were compared. The effect of thyroid function and hemodynamics on the operation was further studied. Results FT4 was performed in 16 patients with primary hyperthyroidism after iodine administration. Peak systolic velocity-PSV and end-diastolic diastolic velocity were observed. EDV) and diameterium diameterus D) were significantly lower than those before iodine administration. There was a positive correlation between FT3 and PSV EDV D before iodization and a negative correlation between TSH and PSV D. After iodine administration, FT3 was positively correlated with PSV D, iodine duration was positively correlated with dFT3, negatively correlated with dTSH, and correlated with dPSV. The time of operation and the amount of intraoperative bleeding were positively correlated with FT _ 3 / PSV _ (D). In the secondary hyperthyroidism group, the PSV D of the superior artery was significantly larger than that of the contralateral superior artery before taking iodine. The diameter of superior artery D of tumor side was significantly different from that of contralateral side after iodine administration. There was a positive correlation between the PSV of the superior artery of goiter and the maximum diameter of the tumor before and after iodine administration. The maximum diameter of the tumor was positively correlated with the time of operation and the amount of intraoperative bleeding. Conclusion the thyroid hemodynamics can reflect the thyroid function to some extent. As a reference index of thyroid function state, the change of its parameters can be used as preoperative intervention. To evaluate the effectiveness of iodide and the quantitative index of choosing the time of operation and to observe the preoperative hemodynamic parameters and thyroid function index, it is helpful to carry out the necessary preoperative intervention in time. To make more reasonable operation plan to ensure the smooth and safe operation.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R653

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