Shigeta O, Makuuchi H, Kaneko Y, Takuma S, Konishi T, Omura M
Department of Cardiovascular Surgery, Yokohama Rosai Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jul;42(7):1096-100.
A 53-year-old female, who had been severe hypothyroidism for about ten years, was admitted Stanford type A acute aortic dissection. The replacement of ascending aorta with a composite graft and coronary artery bypass grafting were performed immediately. During the post operative period, many complications occurred including delayed awakening from anesthesia, paralytic ileus, colon perforation, hyperbilirubinemia, pulmonary edema, cerebral hemorrhage and bacterial endocarditis. In this case, intravenous administration of steroid and thyroid hormone was effective to keep hormone level in the normal range although enteral administration was ineffective. It was suggested that early active supplement therapy is mandatory to prevent postoperative complications.
一名53岁女性，患严重甲状腺功能减退约十年，因斯坦福A型急性主动脉夹层入院。立即进行了升主动脉人工血管置换术和冠状动脉旁路移植术。术后出现了许多并发症，包括麻醉后苏醒延迟、麻痹性肠梗阻、结肠穿孔、高胆红素血症、肺水肿、脑出血和细菌性心内膜炎。在本病例中，静脉注射类固醇和甲状腺激素可有效维持激素水平在正常范围内，而肠内给药无效。提示早期积极补充治疗对于预防术后并发症至关重要。
