在全甲状腺切除术后评估症状性低血症风险:一项前性研究
Andro Košec1,2, Ana Gašić2, Filip Hergešić2
1Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Centre "Sestre milosrdnice," Zagreb, Croatia.
甲状腺切除术后的术后低血症可以通过第一天的副甲状腺激素水平准确预测. 算法和校正公式不能提高低血的预测准确度.
科学领域:
- 内分泌学 在内分泌学.
- 手术并发症 手术并发症
- 临床化学 临床化学
背景情况:
- 甲状腺缺血是全甲状腺切除术后的常见并发症.
- 目前的监测依赖于血清和副甲状腺激素 (PTH) 水平.
研究的目的:
- 确定术后低血症的精确预测因素.
- 开发一个风险评估算法.
- 评估校正公式的有用性.
主要方法:
- 前性,单中心的,非随机的纵向队列研究.
- 205名患者接受了全甲状腺切除术.
- 术后抽取PTH,血清和电离的样本.
主要成果:
- 术后第一天的PTH是症状性低血症最敏感的预测指标 (80.22%的灵敏度,切断值≤2.03 pmol/L).
- 第一天的血清和PTH组合提供了最高的灵敏度 (94%) 和特异性 (89%) 预测低血症.
- 算法和校正公式没有提高预测准确性.
结论:
- 术后第一天的PTH是第五天症状性低血症的最敏感预测因素.
- 复杂的算法和纠正公式对低热血预测的临床实用性有限.
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