Choi Y S, Kwak Y L, Kim J C, Chun D H, Hong S W, Shim J K
Yonsei University College of Medicine, Seoul, Korea.
Anaesthesia. 2009 Aug;64(8):871-7. doi: 10.1111/j.1365-2044.2009.05984.x.
This study evaluated the effect of oral triiodothyronine (T(3)) replacement therapy, starting on the day of the surgery, on thyroid hormone concentrations and clinical outcome in high-risk patients undergoing valvular heart surgery. Fifty patients were randomly allocated to either T(3) or placebo. In the treatment (T(3)) group patients received 20 microg of oral or nasogastric T(3) every 12 h starting just before induction of anaesthesia and until the first day after surgery. T(3) concentrations were significantly higher in the T(3) group than the placebo group from 1 to 36 h after removal of the aortic cross clamp. The number of patients requiring vasopressin after discontinuing cardiopulmonary bypass was significantly greater in the placebo group than the T(3) group. Significantly fewer patients required vasopressors in the T(3) group on the first day after surgery.
本研究评估了从手术当天开始口服三碘甲状腺原氨酸（T₃）替代疗法对接受心脏瓣膜手术的高危患者甲状腺激素浓度和临床结局的影响。50例患者被随机分配至T₃组或安慰剂组。在治疗（T₃）组中，患者从麻醉诱导前开始，每12小时口服或经鼻胃管给予20微克T₃，直至术后第一天。在解除主动脉交叉钳夹后1至36小时，T₃组的T₃浓度显著高于安慰剂组。在停止体外循环后需要血管加压素的患者数量，安慰剂组显著多于T₃组。术后第一天，T₃组需要血管加压药的患者明显较少。
