术后副甲状腺激素 (PTH) 相当于术后的PTH下降,可以预测术后的副甲状腺功能下降
M Hashem1, C B Lim1, S P Balasubramanian1,2
1Sheffield Teaching Hospitals NHS Foundation Trust, UK.
Annals of the Royal College of Surgeons of England
|March 13, 2024
概括
手术后的手术性甲状腺功能低下症 (PoSH) 在甲状腺手术后很常见. 在术后第一天测量副甲状腺激素 (PTH) 有效地预测了短期的低血和长期的副甲状腺功能障碍.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 甲状腺手术 甲状腺手术
背景情况:
- 手术后的手术性甲状腺功能低下症 (PoSH) 是甲状腺切除术后的一种已知的并发症.
- 外科手术期间甲状腺上腺激素 (PTH) 水平是 PoSH 的确定的预测因素.
- 准确预测PoSH对于患者的管理和结果至关重要.
研究的目的:
- 为了比较术前PTH与术后1日PTH下降的预测准确性,用于低血症.
- 评估这些PTH测量在预测长期偏偏甲状腺症的有用性.
- 确定手术前PTH测量是否对于PoSH检测是必要的.
主要方法:
- 在3年内连续接受甲状腺切除术的患者的回顾性分析.
- 包括人口统计,病理学,手术程序和生物化学参数的数据.
- 使用ROC曲线预测低血症和低甲状腺症的第1天PTH和PTH下降的统计比较.
主要成果:
- 在295名患者中,21.7%的患者在术后第1天患有低血症,10.5%的患者在6个月后患有持续性低甲状腺症.
- 第1天的PTH和PTH下降都显著预测了第1天的低血症和6个月的甲状腺上下降 (p < 0.001).
- 接收器运行特征 (ROC) 曲线分析显示,这两项措施的预测性能相似,在第一天PTH方面略有优势.
结论:
- 术后第一天的PTH在预测短期和长期PoSH方面同样有效,甚至比PTH下降更有效.
- 在甲状腺手术后检测或管理PoSH可能不必进行手术前PTH测量.
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