目的 探讨青少年原发性甲状腺功能亢进（甲亢）手术治疗的可行性。方法 本组76例甲亢患者手术麻醉以颈丛神经阻滞加强化为主； 手术方式为甲状腺大部分切除术，切除腺体组织约80%～90%，残留腺体总量约6～8 g。结果 无手术死亡及甲亢危象病例，术后10例（13.2%）发生并发症11例次，经保守治疗后症状消失。术后得到随访（1～15年）的51例患者中有6例于术后5～8年出现甲亢复发，无术后甲状腺功能低下病例。结论 手术治疗青少年甲亢具有快速安全、疗效持久、费用较低、患者愿意接受的特点，临床上是可行的。
目的 探讨甲状腺功能亢进症(甲亢)围手术期T3、T4水平的变化及其临床意义。方法 检测30例甲亢患者服碘及心得安作术前准备前(a)、术日晨(b)、术中(c)、术后第1天(d)及术后第5天(e)各时相点T3、T4水平。结果 全组患者均未发生甲状腺危象，T3、T4水平a＞b＞c＞d＞e，其中a、b、c高于正常值，d、e值在正常范围。结论 经术前准备，甲亢患者符合临床手术条件时，血T3、T4仍然高于正常水平； 手术未造成甲状腺激素大量释放； 术后12及36小时时段甲状腺危象高发期T3、T4水平不高。
Objective To analyze the clinical relationship between primary hyperthyroidism and thyroid carcinoma, and diagnosis and treatment for the combination of the two. Methods The clinical data of 15 patients with primary hyperthyroidism complicated with thyroid carcinoma from January 1998 to December 2008 were retrospectively analyzed. Results Fifteen cases were smoothly discharged. The morbidity was 2.56% (15/585) of primary hyperthyroidism complicated with thyroid carcinoma. There were no operative complications. Five cases showed thyroid nodules and all cases were performed thyroidectomy. Neither hyperthyroidism nor thyroid carcinoma recurred during 9 months to 10 years (average 5.5 years) follow-up.Conclusions The diagnosis of primary hyperthyroidism complicated with thyroid carcinoma is still difficult to be made preoperatively and chiefly depend on postoperative pathology. Rational surgical treatment can result in good effectiveness and better prognosis.
Objective To investigate the diagnosis and treatment of pulmonary arterial hypertension ( PAH) due to rare causes. Methods The clinical presentation, laboratory testing, diagnosis and treatment of 4 patients with PAH associated with rare causes in Beijing Anzhen Hospital from January 2001 to March 2008 were analysed retrospectively. Results Primary biliary cirrhosis, hyperthyroidism, antiphospholipid syndrome and pulmonary artery sarcoma may cause PAH, which were improved after corresponding diagnosis and management. Conclusion PAH can result from rare causes. The enhancement of its recognition will help earlier diagnosis and treatment and improve the prognosis.
目的:探讨甲状腺功能低下的早产儿血清游离三碘甲状腺原氨酸(Free trilute,FT3)、游离甲状腺激素(Free thyroxin,FT4)、促甲状腺激素(Thyroid stimulation hormone,TSH)水平进行动态态变化及临床意义。方法:我院在2007年11月至2008年4月住院的32例诊断为甲状腺功能低下的早产儿为研究对象,应用放射免疫法检测生后第1天,第7天,第15天,1月和2月血清FT3、FT4、TSH水平。结果:32例诊断为甲状腺功能低下的早产儿中,有窒息史的22例,呼吸窘迫综合症(Respiratory distress syndrome,RDS)10例,单纯性早产5例;出现少吃少动临床症状6例;生后各时期的TSH变化没有统计学差异,生后1、5天与生后1、2月FT3、FT4则可见Plt;0.05具有统计学差异。结论:有窒息和RDS的早产儿中,容易发生甲状腺功能降低,以低甲状腺素血症最为常见,使用左旋甲状腺素后,FT-3、FT-4水平可迅速恢复正常。如果同时存在TSH增高,则TSH水平恢复较慢。
【摘要】 目的 总结甲状腺功能亢症（甲亢）患者131I治疗中的护理特点及经验。 方法 2008年1-8月对收治的184例行131I治疗的甲亢患者，依据131I治疗特点采取针对性的护理措施：心理上帮助其消除紧张焦虑的情绪，饮食方面指导禁食碘物，并密切观察病情及预防甲亢危象，对服药中出现的一些不适症状及时对症处理。 结果 184例经131I治疗的甲亢患者3～6个月病情痊愈和缓解153例（83.15%），甲亢复发22例（11.96%），甲状腺功能减退症发生9例（4.89%）。 结论 有效对症的护理措施是甲亢患者积极配合治疗，早日获得康复的重要因素。【Abstract】 Objective To summarize the nursing characteristics and experience for the patients with hyperthyroidism treated by 131I. Methods A total of 184 patients with hyperthyroidism underwent 131I treatment between January and August 2008 were included. We took care of the patients according to the therapeutic features of 131I treatment: helped them calm down, advised not eating iodine-containing food, observed the disease condition and dealt with the discomfort after medicated. Results In 184 patients with hyperthyroidism treated by 131I treatment for three to six months, 153 (83.15 %) were cured, 22 (11.96 %) recurred, and 9 (4.89 %) had hypothyroidism. Conclusion Comprehensive nursing is a key point to make the patients with hyperthyroidism cooperate and recover.