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目的 :测定 13例肺血少紫绀型复杂先天性心脏病患儿围体外循环期血清甲状腺激素的变化。 方法 :患儿年龄 2 0个月～ 6岁 ,分别于麻醉诱导前、停机前 10分、术后 2、4、8、16、2 4、3 6、4 8、72小时取血测定血清总三碘甲状腺原氨酸 ( TT3 )、游离 T3 ( f T3 )、总甲状腺素 ( TT4)、游离 T4( f T4)、促甲状腺激素 ( TSH)及反 T3 ( r T3 )浓度。 结果 :除 r T3 明显升高外 ,各甲状腺激素在体外循环中及术后均明显下降 ,以血清 TT3 、f T3 最为明显 ,至术后 72小时仍呈下降趋势 ,同时不伴有 TSH回升。 结论 :紫绀型复杂先天性心脏病患儿心脏直视手术后甲状腺功能抑制明显 ,恢复缓慢。
Objective: To determine the changes of serum thyroid hormones during cardiopulmonary bypass in 13 children with complicated pulmonary heart disease complicated with congenital heart disease. Methods: The children aged 20 months to 6 years old, before induction of anesthesia, 10 minutes before stopping, after 2, 4, 8, 16, 24, 36, TT3, f T3, TT4, f T4, TSH and anti-T3 (r T3) concentrations were measured. Results: Except for the marked increase of rT3, thyroid hormones decreased significantly during and after cardiopulmonary bypass. The serum TT3 and fT3 were the most obvious, but still decreased at 72 hours postoperatively, but not accompanied by TSH recovery. Conclusions: The thyroid function of the children with cyanotic complex congenital heart disease after cardiac surgery is obvious and the recovery is slow.