Yeung S C, Go R, Balasubramanyam A
Division of Endocrinology, Baylor College of Medicine, Houston, Texas 77030, USA.
Thyroid. 1995 Oct;5(5):403-5. doi: 10.1089/thy.1995.5.403.
We administered potassium iodide and propylthiouracil per rectum, in conjunction with intravenous dexamethasone and propranolol, for emergent treatment of a patient in thyroid storm with small bowel obstruction. Shortly after initiation of this treatment, the patient successfully underwent two emergent surgical procedures for resection of an intestinal volvulus with advanced peritonitis. Serum levels of iodide and propylthiouracil showed substantial absorption of these drugs via the rectal route. Measurement of 24-h urinary-free iodide indicated that the bioavailability of potassium iodide delivered by retention enema was at least 40%. Parenteral iodide preparations have been unavailable in the past, and continue to be difficult to obtain emergently. Rectal administration of inorganic iodide is an effective, readily available and less expensive alternative to parenteral sodium iodide for patients in thyroid storm with upper gastrointestinal tract dysfunction.
我们对一名患有小肠梗阻的甲状腺危象患者进行了直肠给予碘化钾和丙硫氧嘧啶的治疗，同时静脉注射地塞米松和普萘洛尔。在开始这种治疗后不久，患者成功接受了两次紧急手术，以切除伴有严重腹膜炎的肠扭转。血清中的碘化物和丙硫氧嘧啶水平显示这些药物通过直肠途径有大量吸收。24小时尿游离碘的测量表明，保留灌肠给予的碘化钾的生物利用度至少为40%。过去一直无法获得胃肠外碘制剂，现在紧急情况下仍然难以获取。对于患有上消化道功能障碍的甲状腺危象患者，直肠给予无机碘化物是胃肠外碘化钠的一种有效、容易获得且成本较低的替代方法。
