Sarıtaş Aykut, Sarıtaş Pelin Uzun, Kurnaz Muhammed Murat, Çelik Abdullah
Department of Anaestesiology and Reanimation, Prof. Dr. A. İlhan Özdemir State Hospital, Giresun, Turkey.
Department of Cardiothoracic Surgery, Giresun University Faculty of Medicine, Giresun, Turkey.
Turk J Anaesthesiol Reanim. 2015 Aug;43(4):240-5. doi: 10.5152/TJAR.2015.03206. Epub 2015 Mar 3.
An anaesthetic approach and surgery are important treatment strategies in patients with thyroid dysfunction due to potential complications. We investigated the prevalence of thyroid disorders, the significance of thyroid function tests (TFTs) with respect to anaesthesia in the preoperative period and the need for routine examinations.
A total of 10,600 patients who were admitted to the anaesthesiology outpatient clinic for surgery were retrospectively screened and enrolled between 2011 and 2013. Evident hypothyroidism was defined as free tetra-iodothyronine (fT4) <0.7 ng dL(-1) and thyroid-stimulating hormone (TSH) >4 mIU mL(-1), and subclinical hypothyroidism was defined as TSH >4 mIU mL(-1) with normal free hormone levels. Evident hyperthyroidism was defined as fT4 >1.7 ng dL(-1) and TSH <0.1 mIU mL(-1), and subclinical hyperthyroidism was defined as TSH <0.1 mIU mL(-1) with normal free hormone levels. Statistical analysis was conducted using the Statistical Package for the Social Sciences (SPSS) version 17.0. Independent samples t-test and one-way analysis of variance were used to compare the difference between groups.
Of the participants, 8.5% were found to have hypothyroidism, 2.5% had hyperthyroidism, 3.5% received treatment and 2.5% had their treatment postponed. The likelihood of hypothyroidism was greater among females, and no difference was found between genders with respect to hyperthyroidism.
We believe that TFTs are important because of regional factors. However, given the high cost of TFTs and because thyroid dysfunction risk increases with age, we concluded that routine TFTs in young patients with normal physical examination findings are not mandatory.
由于存在潜在并发症，麻醉方法和手术是甲状腺功能障碍患者重要的治疗策略。我们调查了甲状腺疾病的患病率、术前甲状腺功能检查（TFTs）对于麻醉的意义以及常规检查的必要性。
对2011年至2013年间因手术入住麻醉科门诊的10600例患者进行回顾性筛查并纳入研究。明显甲状腺功能减退定义为游离甲状腺素（fT4）<0.7 ng/dL且促甲状腺激素（TSH）>4 mIU/mL，亚临床甲状腺功能减退定义为TSH>4 mIU/mL且游离激素水平正常。明显甲状腺功能亢进定义为fT4>1.7 ng/dL且TSH<0.1 mIU/mL，亚临床甲状腺功能亢进定义为TSH<0.1 mIU/mL且游离激素水平正常。使用社会科学统计软件包（SPSS）17.0版进行统计分析。采用独立样本t检验和单因素方差分析比较组间差异。
参与者中，8.5%被发现患有甲状腺功能减退，2.5%患有甲状腺功能亢进，3.5%接受了治疗，2.5%推迟了治疗。女性患甲状腺功能减退的可能性更大，而在甲状腺功能亢进方面未发现性别差异。
我们认为由于地区因素，TFTs很重要。然而，鉴于TFTs成本高昂且甲状腺功能障碍风险随年龄增加，我们得出结论，对于体格检查结果正常的年轻患者，常规TFTs并非必需。
