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当传统准备治疗不适用时,高剂量普萘洛尔及术中低温在甲状腺切除术中的价值(作者译)

[Value of high dosage propranolol and per-operative hypothermia in thyroidectomy when conventional preparatory treatment is unsuitable (author's transl)].

作者信息

Mellière D, Hazard J, Germain V, Salva A, Perlemuter L, Bernheim R, Cénac A

出版信息

Nouv Presse Med. 1980 May 10;9(21):1497-500.

PMID:7465386
Abstract

Five hyperthyroid patients could be prepared for surgery wit propranolol alone in daily doses of 240 to 400 mg. The drug administered for 3 to 5 days before, and 5 to 15 days after the operation. Following premedication with levopromazine, almost total thyroidectomy was performed under neuroleptanalgesia and moderate hypothermia. The immediate results were satisfactory and free from acute thyrotoxic crisis. On follow-up, 2 to 18 months after surgery 4 patients had clinically and biologically normal thyroid function, and one patient showed evidence of hypothyroidism. For the common forms of the disease the authors use the conventional preparatory treatment. However, they favour a short course of propranolol in high doses either when non-thyroid emergency operations require preliminary treatment of the patient's hyperthyroidism, or when the conventional treatment is ineffective or contra-indicated on account of haematological complications.

摘要

五名甲状腺功能亢进患者仅用普萘洛尔即可为手术做好准备,每日剂量为240至400毫克。术前3至5天及术后5至15天给药。在使用左丙嗪进行术前用药后,在神经安定镇痛和中度低温下进行了几乎全甲状腺切除术。即刻结果令人满意,未发生急性甲状腺毒性危象。随访时,术后2至18个月,4例患者的甲状腺功能在临床和生物学上均正常,1例患者有甲状腺功能减退的迹象。对于该病的常见类型,作者采用传统的准备治疗。然而,当非甲状腺急诊手术需要对患者的甲状腺功能亢进进行初步治疗时,或者当传统治疗因血液学并发症而无效或禁忌时,他们倾向于使用短疗程的高剂量普萘洛尔。

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