اسم المؤلف:
الاء عبد فيصل
اسم المشرف:
رائد معلك حنون الصالح
علي نايف عاصي
المستخلص:
Multinodular goiter defined as the palpation of multiple distinct nodules in the enlarged thyroid gland and it is one of the commonest thyroid diseases encountered in the practice of surgery. Treatment modalities are mainly antithyroid drugs and surgery. The most common surgery being performed for multinodular goitre is subtotal thyroidectomy for the reasons that it is comparatively easier to perform, less time consuming and has a lesser complication rate especially of damage to recurrent laryngeal nerve andparathyroids. Subtotal thyroidectomy involves removal of majority of the diseased thyroid tissue along with the isthmus leaving behind a remnant of roughly 4 - 8 grams on each side.This study was accomplished for evaluation the effect of thyroidectomy on thyroid hormones levels (T3, T4 and TSH) ,serum oxidant - antioxidants status( malondialdehyde (MDA) , ceruloplasmin (Cp), transferrin (Tf ) and albumin (Alb)) , also liver function tests (aspartate amino transferase enzyme (AST), alanine amino transferase enzyme (ALT), alkaline phosphatase (ALP) and total bilirubin (BIL)). Blood samples were obtained from (100) patients with euthyroid goiter, as well as (50) healthy subjects as a control group.The comparison is based on three variables : general comparison ]Group A (Control) : - Included fifty health subjects aged (15 - 60) years. Group B (preoperative) : - Included fifty preoperative patients aged (15 - 60) years. Group C (postoperative) : - Included fifty postoperative patients aged (15 - 60) years[, age ]each one divided into three groups : G 1(15 - 30),G 2 (31 - 40), G 3 (41 - 60)[and according to the time period after surgery ] Post - 1 group : (Less than month). Post - 2group : (From month to year). Post - 3 group : (More than year)[.The results showed that there was a significant increase in MDA, Cp, AST and ALT in all preoperative and postoperative patients in comparison with control group. Yet, Alb, Tf levels showed a significant decrease in all patients groups of preoperative and postoperative in comparison with control group. Also, MDA, Cp, AST and ALT showed a significant increase in postoperative patients in comparison with control group. But, ALP, Alb and BIL showed no significant increase in postoperative patients in compared to control group.While Tf showed a significant decrease in postoperative patients in as compared to the control group. MDA, Cp, AST, ALT, ALP and BIL was decreased in the postoperative group when compared to preoperative group. Yet, Alb, Tf showed a significant increase in postoperative patients group when compared to preoperative group .The results showed a significant increase MDA, Cp, AST, ALT, ALP and BIL in Pre - G1 in comparison with Cont - G1. But, Tf, Alb showed a significant decrease in Pre - G1 in comparison with Cont - G1. Also, MDA, Cp, ALT, ALP and BIL showed a significant increase in Pre - G1 in comparison with Post - G1. While AST showed no significant differences in Pre - G1 as compared to Post - G1. The results showed that there were a significant increase MDA, Cp, AST, ALT and BIL in Pre - G2 in comparison with Cont - G2. But, Alb showed asignificant decrease in Pre - G2 in comparison with Cont - G2. Tf showed a significant decrease in Post - G2 compared to Pre - G2, Cont - G2. While ALP showed no significant differences in all age groups as compared to Cont - G2.Also, MDA, AST and BIL showed a significant decrease in Post - G2 in comparison with Pre - G2. While ALT and ALP showed no significant differences in Pre - G2 as compared to Post - G2.The results showed that there were a significant increase MDA, Cp, AST, ALT, ALP and BIL in Pre - G3 in comparison with Cont - G3. But, Tf and Alb showed a significant decrease in Pre - G3 in comparison with Cont - G3. lso, MDA, Cp, AST and ALT showed no significant differences in Pre - G3 in comparison with Post - G3. While Tf showed a significant increase in Pre - G3 as compared to Post - G3, there were no significant differences in Alb in Pre - G3 and Post - G3 .According to The Time Period there were a significant increase in serum MDA ,Cp concentration in Post - 1and Post - 3 in comparison with Control group(P≤0.05), but there were no significant differences in serum MDA concentration between Post - 2 and Control group (P≤0.05). there were no significant differences in serum Alb, Tf concentration between Post - 1 , Post - 2, Post - 3 and Control group (P≤0.05). there was a significant increase in serum AST concentration in Post - 2, Post - 3 in comparison with control group (P≤0.05), but there were no significant differences in serum AST concentration between Post - 1 and Control group (P≤0.05), there were no significant differences in serum MDA, Cp, AST concentration between Post - 1 , Post - 2, Post - 3(P≤0.05) But, ALT and ALP showed a significant decrease in Post - 1 comparison with Post - 2 and Post - 3, there were no significant differences in serum ALT ,ALP concentration between Post - 1, Post - 2 and control group(P≤0.05), While there was a significant increase in Post - 3 comparison with control. BIL show a significant decrease in Post - 1 comparison with Post - 3.There were no significant differences in Post - 2, Post - 3 in comparison with control. But, BIL show a significant increase in Post - 1 in comparison with control.
