本文關(guān)鍵詞：甲亢患者術(shù)前服碘前后甲狀腺血流動(dòng)力學(xué)及其相關(guān)性因素研究　出處：《暨南大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 甲狀腺功能亢進(jìn)癥 甲狀腺功能 血流動(dòng)力學(xué) 術(shù)前干預(yù) 碘劑

【摘要】：背景本研究的目的是為了探討甲亢患者服碘前后甲狀腺血流動(dòng)力學(xué)變化及其相關(guān)性因素。方法回顧性分析2015年1月-2016年1月收治的甲狀腺功能亢進(jìn)癥患者。收集患者服碘前后甲狀腺功能指標(biāo)、血流動(dòng)力學(xué)參數(shù)、服碘時(shí)間、手術(shù)時(shí)間、術(shù)中出血量等手術(shù)資料。對(duì)比研究服碘前后患者甲狀腺功能、血流動(dòng)力學(xué)參數(shù)及其之間的相關(guān)性,并進(jìn)一步研究術(shù)前甲狀腺功能及血流動(dòng)力學(xué)情況對(duì)手術(shù)的影響。結(jié)果16例原發(fā)性甲亢組在服碘后FT4、收縮期峰值血流速度(peak systolic velocity,PSV)、舒張末期血流速度(end diastolic velocity,EDV)及內(nèi)徑(diameter,D)均較服碘前明顯降低。服碘前FT3與PSV、EDV、D呈正相關(guān),TSH與PSV、D呈負(fù)相關(guān);服碘后FT3與PSV、D呈正相關(guān)。服碘時(shí)間與dFT3呈正相關(guān),與dTSH呈負(fù)相關(guān),與dPSV、dEDV呈正相關(guān)。手術(shù)時(shí)間及術(shù)中出血量與FT3、PSV、D呈正相關(guān)。繼發(fā)性甲亢組服碘前腫物側(cè)上動(dòng)脈PSV、D均明顯大于對(duì)側(cè)上動(dòng)脈;服碘后腫物側(cè)上動(dòng)脈直徑D與對(duì)側(cè)差別有統(tǒng)計(jì)學(xué)意義。在腫物最大徑1cm的10例患者中,服碘前后甲狀腺腫物側(cè)上動(dòng)脈PSV與腫物最大徑的大小呈正相關(guān);腫物最大徑與手術(shù)時(shí)間、術(shù)中出血量呈正相關(guān)。結(jié)論甲狀腺血流動(dòng)力學(xué)可以在一定程度上反映甲狀腺功能狀態(tài),作為甲狀腺功能狀態(tài)的一個(gè)參考指標(biāo)。其參數(shù)變化可作為術(shù)前干預(yù)、評(píng)估碘劑的有效性及選擇手術(shù)時(shí)機(jī)的量化指標(biāo)。將術(shù)前血流動(dòng)力學(xué)參數(shù)與甲狀腺功能指標(biāo)聯(lián)合起來(lái)觀察,有利于及時(shí)進(jìn)行必要的術(shù)前干預(yù)措施,制定更為合理的手術(shù)方案,以確保手術(shù)的順利及安全性。
[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.
【學(xué)位授予單位】：暨南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R653

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