甲状腺上动脉峰值流速与Graves病患者甲状腺激素水平及术中出血量关系的研究

目的研究甲状腺上动脉峰值流速(STA-PSV)与Graves病患者甲状腺激素水平及甲状腺切除术中失血量的关系。方法选取2010年1月到2013年12月确诊并且将实施甲状腺切除术的Graves病患者110例。根据超声检测STA-PSV值将患者分为三组:50 cm/s组、50~100 cm/s组以及100 cm/s组。术前测定各组患者的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平,记录患者术前服用抗甲状腺药物时间、术中出血情况和术后并发症,并进行统计学分析。结果随着患者的STA-PSV的增加,FT3、FT4和TSH也升高,而抗甲状腺药物使用时间减少,术中出血量增多,术后并发症发生率增加(P0.05)。结论 Graves病患者的STA-PSV与甲状腺激素水平、手术失血量以及术后并发症发生率呈正相关。建议将STA-PSV作为甲状腺手术术前评估的常用指标。

The correlation between superior thyroid artery peak systolic velocity and intraoperative blood loss in thyroidectomy for patients with Graves disease

Objective To investigate the correlation of superior thyroid artery peak systolic velocity （ STA - PSV） with thyroid hormone levels and intraoperative blood loss in thyroidectomy for patients with Graves disease. Methods One hundred and ten patients with Graves disease admitted to our hospital from February 2010 to December 2013 were all given subtotal thyroidectomy. According to the grade of STA - PSV, the patients were divided into three groups： 〈50 cm/s, 50 - 100 cm/s and 〉 100 cm/s. The relationship between STA- PSV and free triiodothyro- nine （ FT3 ）, free thyroxine （ FT4）, thyroid - stimulating hormone （ TSH）, treatment time of anti - thyroid drugs, blood loss, and postoperative complications were observed and analyzed. Results With the increase of STA - PSV, FT3, FT4 and TSH increased, while treatment time of anti - thyroid drugs reduced, blood loss increased, incidence of postoperative complications increased （ P 〈 0. 05 ）. Conclusion STA - PSV positively correlated with thyroid hormone levels, intraoperative blood loss and incidence of postoperative complication in patients with Graves disease. It is recommended that the STA - PSV should be used as an indicator for preoperative assessment of thyroid surgery.