A Study Of Short-term Hormonal Changes After Thyroidectomy

ObjectiveTo study the short-term changes in hormone after thyroidectomy,and to analyze the clinical factors that affect the decline of thyroid hormone.Objective to investigate the endocrine therapy and the beginning time of hormone supplementation after thyroidectomy.Methods60 patients with thyroidectomy treated in our hospital in January 2015-January 2017 were randomly selected and divided into two groups according to the different surgical methods.Will accept bilateral subtotal thyroidectomy in 30 cases patients with bilateral subtotal thyroidectomy group,unilateral thyroid and isthmus resection of 30 patients were enrolled in the unilateral thyroid and isthmus resection group.Two groups of patients 1 week before surgery and 5d,15d,30d after surgery,morning fasting venous blood 5ml,IMMULITE1000 automatic immune analysis system and related electrochemiluminescence immunoassay method to detect serum thyroid hormone levels.Results.The serum TT3 and FT3 decreased gradually after thyroid lobectomy.After the operation,5 d began to decreased.The measured data of all time points after thyroid lobectomy were significantly lower than that of preoperative(P<0.05).The level of serum TT4 and FT4 in the patients of this group decreased gradually.15d after lobectomy was significantly lower than that before operation(P<0.05).Serum TT4 was lower than that before operation after thyroid lobectomy when 30d(P<0.05).After TSH,increased gradually from 5d,and still at the high level of normal range.After bilateral thyroid subtotal resection,serum thyroid hormone TT3 and FT3 decreased after surgery,and 5d was significantly lower than that before operation(P<0.05),and the two was lower than the normal reference value.The 5d decreased after thyroidectomy for TT4 and FT4 in this group,which was significantly lower than that before operation(P<0.05).The postoperative 30d was significantly lower than that before the thyroidectomy(P<0.05),Serum TSH increased after bilateral subtotal thyroidectomy,which was significantly higher than that before operation(P<0.05),and then increased gradually.15d after operation was significantly higher than that before operation,and higher than the upper limit of normal range.ConclusionAfter the thyroid lobectomy,the levels of hormones changed dynamically in the short term,and the change trend of thyroid hormones was different in the short run.The onset time of exogenous thyroid hormone replacement therapy and TSH suppression therapy should be given after operation according to TSH level.The compensatory ability of different forms of thyroid after thyroidectomy,unilateral thyroidectomy after thyroid compensatory ability is better.Patients receiving different surgical procedures can decide thyroid hormone after surgery,instead of exogenous thyroid hormone treatment is necessary for difference patient.