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[弥漫性腹膜炎患者用聚乙烯吡咯烷酮碘溶液进行腹腔灌洗后的甲状腺功能]

[Thyroid function after peritoneal lavage with polivinylpyrrolidone-iodine solution in diffuse peritonitis].

作者信息

Görtz G, Häring R, Henckel M, Meinhold H

出版信息

Zentralbl Chir. 1984;109(5):319-30.

PMID:6720126
Abstract

In 36 patients, intraoperative peritoneal lavage with PVP-iodine solution (26 patients) or with the iodine free chemotherapeutic agent Taurolin (10 patients) was performed because of peritonitis. Total iodine serum levels increased considerably after peritoneal lavage with PVP-iodine. In the early postoperative phase, the resorbed iodine was mostly present as iodide in serum. Iodine serum values returned to normal after 30 days. A decrease in T4 and T3 could be observed with a concomitant reciprocal increase of rT3 in the acute phase of peritonitis. Normalization of the thyroid hormone took place after 8 days. A stronger increase in T4 occurred temporarily in 2 of 5 patients known to have thyroid function disorders. These changes in thyroid hormone may also be considered as the consequence of the severe primary disease. Normalization of hormone values was clearly delayed after PVP iodine lavage. The possible risk of an iodine-induced thyrotoxicosis after intraperitoneal application of PVP-iodine is pointed out, and objections are made to using this therapy.

摘要

36例患者因腹膜炎接受了术中腹腔灌洗,其中26例使用聚维酮碘溶液灌洗,10例使用无碘化疗药物托罗林灌洗。用聚维酮碘进行腹腔灌洗后,血清总碘水平显著升高。术后早期,吸收的碘在血清中主要以碘化物形式存在。30天后血清碘值恢复正常。在腹膜炎急性期,可观察到T4和T3降低,同时rT3呈反向升高。8天后甲状腺激素恢复正常。已知有甲状腺功能障碍的5例患者中有2例T4暂时出现更强的升高。甲状腺激素的这些变化也可被视为严重原发性疾病的后果。聚维酮碘灌洗后激素值的正常化明显延迟。指出了腹腔内应用聚维酮碘后碘诱导甲状腺毒症的潜在风险,并对使用这种治疗方法提出了异议。

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