Pérez J A, Silva R, Norambuena L, López B, Valencia V, Kinast C, Iribarren O
Instituto de Cirugía, Medicina Interna y Anatomía Patológica, Facultad de Medicina, Universidad Austral de Chile.
Rev Med Chil. 1991 Oct;119(10):1123-7.
Conventional preparation of goitrous hyperthyroid patients using lugol and propranolol may take 2 weeks. This period may be shortened using sodium iopodate and dexamethasone. We used 500 mg of sodium iopodate and 1 mg dexamethasone for 4 days in 34 hyperthyroid patients. Surgical indication derived from failure to medical treatment (68%), large goiter (27%) or adverse reaction to PTU (6%). Clinical euthyroidism was achieved after 4 days in all patients. T3 levels decreased from 482 +/- 26.2 to 137.6 +/- 3.7 ng/dl and T4 from 20.6 +/- 1.04 to 15.2 +/- 0.5 micrograms/dl (p < 0.005). Surgery was uneventful in 33 patients, one subject developed supraventricular tachycardia responsive to verapamil. Electron microscopy of the removed thyroid tissue revealed marked decrease of superficial villi and large phagosomes. Thus, sodium iopodate and dexamethasone are effective and safe for preoperative preparation of hyperthyroid patients.
使用卢戈氏碘液和普萘洛尔对甲状腺肿大的甲亢患者进行常规准备可能需要2周时间。使用碘番酸钠和地塞米松可缩短这一时期。我们对34例甲亢患者使用500毫克碘番酸钠和1毫克地塞米松，持续4天。手术指征源于内科治疗失败（68%）、巨大甲状腺肿（27%）或对丙硫氧嘧啶的不良反应（6%）。所有患者在4天后均实现临床甲状腺功能正常。T3水平从482±26.2降至137.6±3.7纳克/分升，T4从20.6±1.04降至15.2±0.5微克/分升（p<0.005）。33例患者手术顺利，1例出现对维拉帕米有反应的室上性心动过速。切除的甲状腺组织的电子显微镜检查显示表面绒毛和大吞噬体明显减少。因此，碘番酸钠和地塞米松对甲亢患者的术前准备有效且安全。
