抄録
17 cases of hyperthyroidism were surgically treated with good results. For preoperative medication, we used methylthiouracil in 11 cases, Lugol's solution in one case and combiation of both drugs in 5 cases. Methylthiouracil was given orally; 0.6g per day. This generally gave rapid and excellent effects within a few weeks. Body weight increased, pulse rate and basal metabolic rate decreased and psychic conditionn became better. We directed the time of operation, when basal metabolic rate became less than 30%.
Most cases reached at this point in two weeks. In case methylthiouracil was ineffective, combination of methylthiouracil and Lugol's solution was administered. In two cases, due to side reactions, especially, generalized exanthema, methylthiouracil medication was discontinued and substituted with Lugol's solution.
Circulating blood volume was carefully checked during the entire course. Apparent increase was observed. It was 101.9cc/kg in average at the time admission. It became 88.9cc/kg at the end of the preoperative medication period, Circulating blood volume was measured at the 1, 3, and 7th days after operation and also before discharging from hospital.
It decreased also after operation, with exception of slight increase at the third postoperative day. It became normal level (76.2cc/kg in average) immediately before discharging from hospital.
According to our previous knowledge, typical postoperative reactions may be observed, in case Lugol's solution is given preoperatively. The main side reactionn shall be the disorder of cardiovascular system. Therefore we expected some great changes in the circulating blood volume by operation.
However, we had only case, which shown a decrease of 950cc/kg of the circulating blood volume. No case of typical postoperative reaction was experienced.
We performed the subtotal strumectomy upon all cases. The histological findings were as follows; struma colloides micro-or macrofollicularis in 11 cases and strurna parenchymatosa papillaris in 6 cases. We recognized remarkable degenerative changes in the parenchymal cells of the thyroid.
