游离甲状腺激素和促甲状腺激素在二氧化碳气腹手术中的变化及其意义

目的 :探讨在二氧化碳气腹下腹腔镜胆囊切除术中游离T3 (FT3 )、游离T4(FT4)和促甲状腺激素 (TSH)的变化及其意义。方法 :4 2例腹腔镜胆囊切除术患者在麻醉前、气腹前、气腹后 10min、气腹后 30min及气腹毕各个时间点抽取静脉血标本 ,放免法检测FT3 、FT4、TSH浓度 ,同时记录生命体征变化。结果 :FT4在气腹后 10min、 30min及气腹毕明显升高 (P <0 0 1) ,TSH和FT3在气腹前后与麻醉前相比 ,差异无显著性 ;。结论 :气腹可明显影响FT4浓度 ,导致应激反应增强。对原有甲亢病的患者施行气腹时应引起注意 ,以免造成意外。

The Alterations and Significance of Free 3-Idione-Thyronine, Thyroxone and Thyroid Stimulating Hormon During CO_2 Pneumoperitoneum

Objective: To study the changes of free 3-idione-thyronine (FT 3), free thyroxone (FT 4) and thyroid stimulating hormon (TSH), and their significance during CO 2 pneumoperitonum. Methods:42 cases of patients undergoing laparoscopic cholecystectomy were randomly chosen. Venous blood samples were drawn to measure FT 3, FT 4 and TSH by radioimmunoassay during the following time intervals: before anesthesia and insufflation, 10 and 30 min after insufflation and deflation. The vital signs were recorded simultaneously. Results: There were no significant changes in FT 3 and TSH compared with preanesthesia value; FT 4 was significantly increased following insufflation (p<0.01). Conclusion:CO 2 pneumoperitonum can obviously interfere with FT 4. Special attention should be paid during CO 2 pneumoperitoneum to the patients who have suffered from hyperthyroidism.