术中甲状旁腺激素测定评判继发性甲状旁腺功能亢进手术成功的标准构想

doi:10.6040/j.issn.1673-3770.0.2015.529

Abstract

Abstract: Objective Evaluation of intraoperative parathyroid hormone(IOPTH)measurement for predicting successful surgery in patients undergoing near or total parathyroidectomy due to secondary hyperparathyroidism(SHPT). Methods The near or total parathyroidectomy were performed in 105 cases of SHPT. Parathyroid hormone assay were measured in operation after induction of anaesthesia but before incision(PTH₀)and 10 min(PTH₁₀)after last parathyroid was excised. The success criteria of indicating surgery in near or total parathyroidectomy were used as follow: (1) PTH₁₀≤150 pg/m, (2) a relative of PTH₁₀/PTH₀≤30%. Results 96 cases of successful operation met the criteria. Comparing to unsuccessful criteria, the decline of PTH had significant difference. Decline of calcium levels of these patients was evident after the surgery. The causing false positive rates and recurrence rates was 9.38% and 23.33% separately when it set normal PTH or low PTH as the curing criterion after 6 months follow-up. And the recurrence rates was 5% if It was PTH<300 pg/mL in the curing criterion according to K/DOQI guidelines. Decline of calcium and phosphorus in true positive cases compare to pre-operation had significant difference but it was not change in no successive criterion cases. Conclusion PTH₁₀/PTH₀≤30% was appropriate to predicte success of near or total parathyroidectomy for patients with SHPT.

Key words: Secondary hyperparathyroidism, Near/Total parathyroidectomy, Parathyroid hormone, Intraoperative PTH assay

CLC Number:

R692.1

LIU Xinjie, XU Nan, CAI Wei, GAO Hengyuan, LUO Min, DENG Huiyi, ZHOU Dongxian. Conception of successive criterion of intraoperative parathyroid hormone assay during parathyroidectomy in secondary hyperparathyroidism.[J].JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(2): 65-70.

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Conception of successive criterion of intraoperative parathyroid hormone assay during parathyroidectomy in secondary hyperparathyroidism.

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