术后第一天甲状旁腺激素水平对甲状腺全切术后甲状旁腺功能恢复的预测价值

doi:10.6040/j.issn.1673-3770.0.2017.336

Abstract

Abstract: Objective To explore whether parathyroid hormone(PTH)levels on postoperative day 1 can predict the recovery of parathyroid function by determining the PTH levels on postoperative days 1, 3, and 30 in patients who underwent total thyroidectomy. Methods The clinical data of 68 patients treated with total thyroidectomy between September 2014 and December 2016 were retrospectively analyzed. The PTH levels were determined on postoperative days 1, 3, and 30. The patients were then divided into three groups on the basis of PTH levels on postoperative day 1: Group A, PTH<5 pg/mL; Group B, 5 pg/mL≤PTH<10 pg/mL; and Group C, PTH≥10 pg/mL. Results Higher PTH levels on postoperative day 1 correlated with lower incidence rates of low parathyroid function. On postoperative day 3, there was a difference between Groups A and C, and Groups B and C. Again, on postoperative day 30, there was a difference between Groups B and C. Conclusion If PTH levels on postoperative day 1 are less than 5 pg/mL, it is difficult to recover normal levels and hypocalcemia will occur within 30 days. However, if PTH levels on postoperative day 1 are ≥10 pg/mL, it is easier to recover normal levels.

Key words: Parathyroid hormone, Total thyroidectomy, Hypocalcemia

CLC Number:

R653

HUANG Tianqiao, JIANG Xiaodan, CHE Fei, HUANG Yichuan, SUN Yan, ZHANG Niankai, LI Shenling, CHEN Zhijun, LI Wei. Value of parathyroid hormone levels on postoperative day 1 for predicting parathyroid function after total thyroidectomy.[J].JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(5): 89-91.

References

[1] Lombardi CP, Raffaelli M, Princi P, et al. Early prediction of postthyroidectomy hypocalcemia by one single iPTH measurement[J]. Surgery, 2004, 136(6):1236-1241.
[2] 安常明,唐平章,张彬.甲状腺全切除术后低钙血症的预测及治疗[J].中华耳鼻咽喉头颈外科杂志,2009,44(8):698-700. AN Changing, TANG Pingzhang, ZHANG Bin. Prediction and treatment of the hypocalcemia after total thyroidectomy[J]. Chin J Otorhinolaryngol Head Neck Surg, 2009, 44(8):698-700.
[3] Thompson NW, Olsen WR, Hoffman GL. The continuing development of the technique of thyreidectomy[J]. Surgery, 1973, 73(6):913-927.
[4] Olson JA Jr, De Benedetti MK, Banmarm DS, et al. Parathyroid autotransplantation during thyroidectomy.Results of long—term follow-up[J]. Ann Surg, 1996, 223(5):472-478; discussion 478-480.
[5] 龚建春,张海东,于振坤.精细化甲状腺腺叶切除操作技术[J].山东大学耳鼻喉眼学报,2016,30(2):5-9.
[6] Gac EP, Cabane TP, Amat VJ, et al. Incidence of hypocalcemia after total thyroidectomy[J]. Rev Med Chil, 2007, 135(1):26-30.
[7] 胡荣生,于伟,李秋波.甲状腺手术中甲状旁腺损伤的预防及低钙血症应对措施[J].中国普通外科杂志,2013,22(5):664-666.
[8] 陈闯,赵斌,丁巍.甲状腺全切术后第一天甲状旁腺激素测定的临床意义[J].中华内分泌外科杂志,2014,8(1):15-17.
[9] Kim JP, Park JJ, Son HY, et al. Effectiveness of an i-PTH measurement in predicting post thyroidectomy hypocalcemia: prospective controlled study[J]. Yonsei Med J, 2013, 54(3):637-641.
[10] Car AA, Yen TW, Fareau GG, et al. A single parathyroid hormone level obtained 4 hours after total thyroidectomy predicts the need for postoperative calcium supplementation[J]. J Am Coll Surg, 2014, 219(4):757-763.
[11] Puzziello A, Gervasi R, Orlando G, et al. Hypocalcemia after total thyoidectomy: could intact parathyroid hormone be a predictive factor for transient postoperative hypocalcemia[J]. Surgery, 2015, 1572(2):344-348.
[12] Del Rio P, Areuri MF, Ferrerl G, et al. The utility of selMm PTH assessment 24 hours after total thyroidectomy[J]. Otolaryngol Head Neck Surg, 2005, 132(4):584-586.
[13] Schlottmann F, Campos Arbulu AL, Sadava EE, et al. Algorithm for early discharge after total thyoidectomy using PTH to predict hypocalcemia: prospective study[J]. Langenbecks Arch Surg, 2015, 400(7):831-836.
[14] Scurry WC Jr, Beus KS, Hollenbeak CS, et al. Perloperative parathyroid hormone assay for diagnosis and management of postthyroidectomy hypocalcemia[J]. Laryngoscope, 2005, 115(8):1362-1366.
[15] Soon PS, Magarey CJ, Campbell P, et al. Serum intact parathyroid hormone as a predictor of hypocalcaemia after total thyroidectomy[J]. ANZ J Surg, 2005, 75(11):977-980.
[16] Toniato A, Boschin IM, Piotto A, et al. Thyroidectomy and parathyroid hormone:tracing hypocalcemia-prone patients[J]. Am J Surg, 2008, 196(2):285-288.

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Value of parathyroid hormone levels on postoperative day 1 for predicting parathyroid function after total thyroidectomy.

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