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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Intraoperative parathyroid hormone levels in thyroid and parathyroid surgery.
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Intraoperative parathyroid hormone levels in thyroid and parathyroid surgery.

机译：甲状腺和甲状旁腺手术中的术中甲状旁腺激素水平。

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OBJECTIVE To determine the utility of intraoperative parathyroid hormone measurement in predicting postoperative hypocalcemia after thyroid and parathyroid surgeries that places total parathyroid function at risk.STUDY DESIGN Retrospective case review.METHODS The case records of 23 patients undergoing total or completion thyroidectomy and 30 patients undergoing parathyroid exploration were reviewed. All patients had intraoperative parathyroid hormone levels measured. Samples were taken before dissection and 10 minutes after the resection was completed. Serial ionized calcium levels were measured in the postoperative period. Percentages of reduction in PTH levels from preoperative to postresection levels were calculated. Percentages of reduction in PTH level and the absolute value of the intraoperative PTH values were compared with postoperative ionized calcium levels.RESULTS In the 23 patients who underwent thyroid surgery, the average preoperative and postoperative PTH values were 50 pg/mL (range, 17-87 pg/mL) and 34 pg/mL (range, 4-93 pg/mL), respectively. The average decrease in PTH was 39% (range, 39%-90%). The incidence of hypocalcemia was significantly higher in patients with intraoperative PTH levels less than 15 pg/mL relative to patients with PTH levels greater than 15 pg/mL in this setting ( =.006). In the 30 patients who underwent parathyroid exploration, average preoperative and postoperative PTH levels were 291 pg/mL (range, 65-1675 pg/mL) and 113.8 pg/mL (range, 6.5-1263 pg/mL) respectively. The intraoperative PTH level did not correlate with postoperative calcium levels in the parathyroid group. Percentages of decrease in PTH levels greater than 60% was statistically associated with surgical cure in this population.CONCLUSIONS The study demonstrates that intraoperative PTH levels greater than 15 pg/mL after total or completion thyroidectomy indicate a low risk of postoperative hypocalcemia and that these patients may be candidates for outpatient surgery. In the parathyroid group, intraoperative PTH levels do not correlate well with postoperative calcium levels.
机译：目的确定术中甲状旁腺激素的测量在预测甲状腺和甲状旁腺手术后低钙血症的风险中的作用，从而降低甲状旁腺的全部功能研究设计回顾性病例回顾方法23例接受全或全甲状腺切除术和30例甲状旁腺切除术的病例记录探索进行了审查。所有患者术中均测定了甲状旁腺激素水平。解剖前和解剖完成后10分钟取样。在术后期间测量一系列的离子钙水平。计算了术前至切除后PTH水平降低的百分比。将PTH水平降低的百分比和术中PTH值的绝对值与术后电离钙水平进行比较。结果在23例接受甲状腺手术的患者中，术前和术后PTH的平均值为50 pg / mL（范围为17- 87 pg / mL）和34 pg / mL（范围4-93 pg / mL）。 PTH的平均下降幅度为39％（范围为39％-90％）。在这种情况下，术中PTH水平低于15 pg / mL的患者相对于PTH水平高于15 pg / mL的患者，低钙血症的发生率明显更高（= .006）。在接受甲状旁腺探查的30例患者中，术前和术后PTH平均水平分别为291 pg / mL（范围65-1675 pg / mL）和113.8 pg / mL（范围6.5-1263 pg / mL）。甲状旁腺组术中PTH水平与术后钙水平不相关。结论：该研究表明，甲状腺全切除术或完全切除术后术中PTH水平高于15 pg / mL，表明PTH水平降低大于60％的百分比与手术治愈相关。结论这些患者术后低血钙的风险较低，这些患者可能是门诊手术的候选人。在甲状旁腺组，术中PTH水平与术后钙水平没有很好的相关性。

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