【摘要】 目的 探讨Graves’病手术期间应激反应与血清皮质醇(COR)相关性。方法 用Immulite法测定18例Graves’病患者次全切除术前1日(A时段)、术晨(B时段)、进入手术室(C时段)、安置甲状腺手术体位后(D时段)、处理甲状腺上下极后(E时段)5个时间段的血清COR，记录并分析同期脉搏、血压的变化。结果 (1)5个时段的COR、脉搏、收缩压均逐渐升高，从C时段开始有明显改变(P<0.05);A、B、C、D时段的舒张压变化差异无显著性(P均>0.05);E时段的COR、脉搏、血压值均明显高于A、B、C、D时段(P均<0.01)。(2)5个时段的COR与脉搏、收缩压均有相关性(P<0.05或<0.01)，仅E时段的COR与舒张压有相关性(P<0.05)。结论 Graves’病手术期间应激可不同程度地促进COR的合成和分泌, 应制定必要的医疗措施减轻应激反应。

    【关键词】 Graves’病；应激; 皮质醇; 手术

    Relativity between serum cortisol and stress of Graves’ disease patients in operative period

    YE Jian，HE Jin-song.

    Department of Surgery,Pingdi People's Hospital,Shenzhen 518117，China

    【Abstract】 Objective To study relationship of serum cortisol(COR) and stress of Graves’ disease patients in operative period.Methods The serum cortisol were detected on 18 Graves’ disease patients by Immulite method 1 day before subtotal thyroidectomy(A stage), operative morning(B stage),after entering operative room(C stage),after putting operative position(D stage)and after cutting off upper and lower part of thyroid (E stage).At the same time, the pulse(P) and blood pressure(BP) were examined and analyzed. Results (1)COR, P,systolic BP were gradually increased in 5 stages of operative period,the changes were significant difference after B stages(P<0.05). The changes of diastolic BP were no significant difference among A,B,C and D stages (P>0.05). COR, P, BP in E stages were more higher than A,B,C and D stages (P<0.01),respectvely. (2)COR were significant relative to P and systolic BP of 5 stages(P<0.05),respectvely. COR was significant relative to diastolic BP in E stages(P<0.05), only. Conclusion The synthesis and secretion of COR may be promoted by psychological and physiological stress for Graves’ disease patients in operative period. Essential medical strategies may be important to reduce the stress complication. ......