丙泊酚全身麻醉下乳腺癌根治术患者血清甲状腺激素水平变化

目的：探讨丙泊酚全身麻醉下乳腺癌根治术前后甲状腺激素（TH）的变化。方法：29例乳腺癌Ⅰ～Ⅱ期的患者,ASAⅠ～Ⅱ级,年龄30～50岁,行择期乳腺癌根治术。麻醉手术前及术毕取血检测T3、T4、FT3、FT4和TSH,并检验上述指标手术前后差值（dTH,TH术前-TH术后）与丙泊酚公斤体重总用量（P／W）之间的相关性。结果：与麻醉手术前相比,乳腺癌根治术患者术后T3、T4、FT3,和TSH水平均降低;其中dTs和dFT4与P／W明显正相关（r=0．445,P=0．016）,而dFT3与P／W呈明显负相关（r=-0．414,P=0．025）,其他指标与P,W无明显相关性。结论：丙泊酚静脉麻醉下乳腺癌根治术患者血清TH水平下降,并且随着P／W的增加,T3降低越严重。

Changes of the serum level of thyroid hormone in breast cancer patients undergoing general anesthesia with propofol and radical mastectomy

Objective: To investigate the changes of thyroid hormone(TH) before and after general anesthesia with propofol and radical mastectomy.Methods: 29 patients with breast cancer,TNM at Ⅰ-Ⅱ,ASA classification at Ⅰ-Ⅱ and aged between 20-60 years old,were all undergoing selective radical mastectomy.Blood was taken before and after the anesthesia and surgery for the detection of the serum concentration of T3,T4,FT3,FT4and TSH.Correlation between the total dose of propofol per kilogram of bodyweight(P/W) and the changes of parameters(dTH,THPRE-THPOST) above-mentioned was also checked.Results: Compared with the preoperative ones,postoperative T3,T4,FT3and TSH decreased significantly.There were positive correlations between dT3,dFT4and P/W(r=0.445,P=0.016),and there was negative correlation between dFT3and P/W(r=-0.414,P=0.025),but none with other dTHs.Conclusion: General anesthesia with propofol and radical mastectomy might make TH decrease in breast cancer patient.Higher the P/W increased,lower the T3became.