ABSTRACT
Three hundred and nine patients with thyroid nodules detected by physical examination in Harrison International Peace Hospital from October 2013 to October 2017 were divided into intervention group (155 cases) and control group (154 cases). Patients in intervention group received oral levothyroxine sodium 25 g / d for 12 months and those in control group had no treatment, patients were followed up every 3 months to 12 months. After treatment, the maximum diameter and thyroid nodule volume of the intervention group were (31.87±3.84) mm and (17.32±0.94) cm3, which were significantly smaller than those of the control group [(34.01±3.72) mm and (24.25±1.21)cm3, P<0.05]. TSH in intervention group was lower than that in control group [(2.24±0.41) vs. (2.52±0.58) mIU/L, P<0.05] and free T4 (FT4) was higher than that in control group [(25.64 ± 3.85) vs. (16.39 ± 3.28) pmol/ L, P<0.05]. TC, TG and LDL?C in intervention group, were lower than those in the control group .The HDL?C level in intervention group was higher than that in control group (all P<0.05). After treatment, there were no malignant changes in the intervention group, while the malignant change rate in control group was 2.6％ (4/154). It is suggested that levothyroxine treatment can reduce TSH level in patients with benign thyroid nodules, inhibit the growth of thyroid nodules.
ABSTRACT
Objective To investigate the impact of enhanced recovery after surgery (ERAS) program on postoperative recovery in patients undergoing laparoscopic colorectal resection. Methods Eighty-four patients undergoing laparoscopic colorectal resection from March 201 5 to June 201 6 (55 males,29 females,aged 36-78 years,ASA physical status Ⅰ or Ⅱ),were randomly divid-ed into two groups (n = 38 each).Patients in group E were received epidural block combined with general anesthesia,and a series of perfect ERAS strategies,such as strengthen preoperative educa-tion, maintaining perioperative normothermia, perioperative goal-directed fluid therapy, intraoperative and postoperative analgesia.While the patients in group C received routine anesthetic management.The volume of fluid,the nasopharyngeal temperature,the time of recovery of bouel sound,first anal exhaust,eating fluid food,ambulation and remove of the catheter were recorded in two groups.Furthermore,time of PACU after surgery,the total days of hospitalization and total hos-pital costs were recorded.Results The volume of fluid [(1 328 ± 64)ml vs.(2 463 ± 135 )ml]in group E were significantly lower than group C (P <0.05),the nasopharyngeal temperature [(36.2± 0.2)℃ vs.(35.1±0.5)℃]was significantly higher in group E (P <0.05).Compared with group C,the time of recovery of bowel sound [(33.4 ± 12.5 )h vs.(42.8 ± 14.3 )h],first anal exhaust [(43.6±13.9)h vs.(60.7±1 5.4)h],eating fluid food [(26.8±4.1)h vs.(67.4±13.5)h],first ambulation [(7.4±1.6)h vs.(26.5±3.8)h]and remove of the catheter [(29.2±6.1)h vs.(5 1.8 ±7.6) h ], time of PACU [(26.4 ± 8.5 ) min vs.(37.2 ± 1 1.6 ) min ], the total days of hospitalization [(7.5±0.9)d vs.(9.7±1.2)d]were significantly shorter (P <0.05),and hospital costs [(2.1±0.6)ten thousand yuan vs.(2.6±0.8)ten thousand yuan]were significantly decreased (P <0.05).The incidence of adverse reactions such as nausea and vomiting (2.4% vs.21.4%),pru-ritus (7.1% vs.23.8%),agitation (4.8% vs.26.2%)and chills (0% vs.1 9.0%)were significantly lower in group E (P <0.05).Conclusion ERAS program applied to patients undergoing laparoscopic colorectal resection can reduce the intraoperative sufentanil consumption,avoid the occurrence of postoperative hypothermia, accelerate recovery of gastrointestinal function, which can obviously reduce the hospitalization costs and shorten the hospitalization time.