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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 .. >Evaluation of intraoperative parathormone measurement for predicting successful surgery in patients undergoing subtotal/total parathyroidectomy due to secondary hyperparathyroidism.
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Evaluation of intraoperative parathormone measurement for predicting successful surgery in patients undergoing subtotal/total parathyroidectomy due to secondary hyperparathyroidism.

机译：评估术中甲状旁腺激素水平以预测因继发性甲状旁腺功能亢进而进行次全/次甲状旁腺切除术的患者的成功手术。

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OBJECTIVES/BACKGROUND: The aim of this study is to investigate the predictive value of intraoperative parathormone measurement addressing successful surgical resection in patients with secondary hyperparathyroidism. METHODS: The study included 42 consecutive patients operated on between May 2006 and July 2008. Patients were grouped according to successful surgery (Group 1, n = 36) and persistent postoperative hyperparathyroidism (Group 2, n = 6). Serum phosphorus (P), total calcium (tCa), ionized calcium (iCa), intact parathormone (iPTH), and alkaline phosphatase (ALP) were drawn preoperatively and intraoperatively upon 15 minutes after completion of resection (iPTH(15)). The rate of decrease of pith detected by iPTH(15) compared to preoperative values was calculated (iPTH(%)). RESULTS: Preoperative P, tCa, iCa, iPTH, and ALP were comparable. Subtotal parathyroidectomy (sPx) (n = 27) and total parathyroidectomy with autotransplantation (tPx) (n = 15) were performed. Mean iPTH(15) value, iPTH(%) rates were 145.9 +/- 12.3 pg/mL, % 91.6 +/- 0.7, and 522.5 +/- 85.4 pg/mL, % 75.1 +/- 2.0 (P = ,001) in Groups 1 and 2, respectively. Mean serum tCa and iCa at POD#1 in Group 1 were 7.6 +/- 0.1 mg/dL, 0.910 +/- 0.4 mmol/L, and Group 2 were 8.3 +/- 0.3 mg/dL, 1.050 +/- 0.4 mmol/L (P < .05), respectively. ALP levels were similar. CONCLUSION: iPTH(15) value and iPTH(%) rate accurately predicts the completeness of resection in secondary hyperparathyroidism. The rate of decrease in serum iPTH detected intraoperatively compared to preoperative baseline levels exceeding 90% in sPx, 95% in tPx, accurately predicts the success of surgery. Postoperative normocalcemia without calcium replacement would raise a suspicion about completeness of surgical resection.
机译：目的/背景：本研究的目的是探讨术中甲状旁腺激素测定对继发性甲状旁腺功能亢进患者成功手术切除的预测价值。方法：该研究包括2006年5月至2008年7月之间连续手术的42例患者。根据成功手术（第1组，n = 36）和术后持续甲状旁腺功能亢进（第2组，n = 6）对患者进行分组。切除完成后15分钟，术前和术中抽取血清磷（P），总钙（tCa），离子钙（iCa），完整副甲状腺激素（iPTH）和碱性磷酸酶（ALP）。计算出iPTH（15）检测到的髓鞘减少率与术前值相比的下降率（iPTH（％））。结果：术前P，tCa，iCa，iPTH和ALP相当。进行了亚大体甲状旁腺切除术（sPx）（n = 27）和带自体移植的全甲状旁腺切除术（tPx）（n = 15）。平均iPTH（15）值，iPTH（％）率为145.9 +/- 12.3 pg / mL，％91.6 +/- 0.7和522.5 +/- 85.4 pg / mL，％75.1 +/- 2.0（P =，001 ）分别位于第1组和第2组中。第1组POD＃1的平均血清tCa和iCa为7.6 +/- 0.1 mg / dL，0.910 +/- 0.4 mmol / L，第2组为8.3 +/- 0.3 mg / dL，1.050 +/- 0.4 mmol / L（P <.05）。 ALP水平相似。结论：iPTH（15）值和iPTH（％）率可准确预测继发性甲状旁腺功能亢进的切除术的完整性。与术前基线水平在sPx中超过90％，在tPx中超过95％相比，术中检测到的血清iPTH降低率准确地预测了手术的成功。没有钙替代的术后正常血钙过多会引起人们对手术切除是否完整的怀疑。

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