围手术期小儿急性阑尾炎血清甲状腺激素检测

用放射免疫测定法对５２例小儿急性阑尾炎进行围手术期血清三碘甲状腺原氨酸（Ｔ３）、四碘甲状腺原氨酸（Ｔ４）、反Ｔ３（ｒＴ３）及促甲状腺激素（ＴＳＨ）测定，并与正常对照组进行了比较。结果表明，手术前血清Ｔ３，Ｔ４明显降低，ｒＴ３明显升高，差异均有显著性或极显著性（Ｐ＜０．０５或０．０１）。阑尾穿孔组血清Ｔ３明显低于未穿孔组，ｒＴ３则相反。阑尾切除术后３ｄ，甲状腺激素水平开始恢复，７ｄ恢复正常。病情危重和术后合并感染者，血清Ｔ３，Ｔ４明显降低。提示对急性阑尾炎病儿进行围手术期甲状腺激素动态监测，有助于了解病情及估计预后。

THYROID HORMONE CHANGES IN CHILD APPENDICITIS DURING PERIOPERATIVE PERIOD

Serum T3,T4 and rT3 were determined by radioimmunoassay in 52 child patients with acute appendicitis. The results showed that the patients had much lower levels of serum T3(P<0. 01) and serum T4(P<0.05) but remarkably higer levels of serum rT3(P<0. 01) than the controls. The patients with perforated appendixes showed lower levels of serum T3 but higher levels of serum rT3 than those without perforation. Dramatically decreased levels of serums T3 and T4 indicates that the case is serious or there is an infective complication. The perioperative determination of thyroid hormones is therefore very important in evaluating the severity of the illness and its prognosis.