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目的 :探讨先天性心脏病 (先心病 )患儿在围体外循环 (CPB)期甲状腺激素的动态变化与临床意义。方法 :用放射免疫法测定 3 1例先心病 CPB手术 (I组 )围术期的血清甲状腺素水平 ,并与9例普通胸科手术者 ( 组 )作对照。结果 :I组术后即刻出现低 T3、T4,并逐渐加重 ,持续 3～ 5 d后 ,恢复至术前水平 ; 组手术前后甲状腺素水平对比差异无显著意义 (P>0 .0 5 )。 I组术后 FT3水平≤正常值低限者需要机械通气、吸氧、IUC时间及总住院日数均较 >正常低限值者显著延长(P<0 .0 5 )。未发现年龄、体重、CPB时间、病种对 FT3降低幅度有明显影响。结论 :先心病术后发生的一过性低 T3、T4综合征与 CPB有关 ,与术后心肺功能有一定关系 ,与病种、年龄、体重、CPB时间无关。
Objective: To investigate the dynamic changes and clinical significance of thyroid hormones during cardiopulmonary bypass (CPB) in children with congenital heart disease (CHD). Methods: Perioperative serum thyroxine levels in 31 patients with congenital heart disease (CPB) were measured by radioimmunoassay, and compared with 9 patients undergoing general thoracic surgery. Results: Low T3 and T4 appeared immediately after operation in group I, and gradually increased after operation for 3 to 5 days. The level of thyroxine was not significantly different between before and after operation (P> 0.05). In group I, the patients with FT3 level ≤ the lower limit of normal need mechanical ventilation, oxygen inhalation, IUC time and total hospitalization days were significantly longer than the normal low limit (P <0.05). Did not find the age, weight, CPB time, disease significantly reduced the extent of FT3. Conclusions: The transient low T3 and T4 syndrome after CHD is related to CPB, and has certain relationship with cardiopulmonary function after operation. It has nothing to do with disease type, age, body weight and CPB time.