术内甲状腺激素测量对术后甲状腺功能在接受全甲状腺切除术的患者中的预测作用
Yushuai Zhang1, Yishen Zhao1, Hong Tang2
1Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Translational Medicine in Surgery, Jilin Provincial Engineering, Laboratory of Thyroid Disease Prevention and Treatment, 126 Xiantai Street, Changchun, 130033, China.
Scientific reports
|November 26, 2024
概括
术内副甲状腺激素 (IOPTH) 水平有效预测全甲状腺切除术后的低血症. 监测IOPTH和副甲状腺激素 (ΔPTH%) 的变化有助于评估副甲状腺功能恢复,并识别有风险的患者.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 神经外科 神经外科
背景情况:
- 甲状腺切除术,特别是全甲状腺切除术后,低血是经常出现的并发症.
- 在手术期间意外的甲状腺损伤是甲状腺切除术后低血症的主要原因.
研究的目的:
- 评估手术内副甲状腺激素 (IOPTH) 在住院期间低血症的预测能力.
- 评估IOPTH在确定全甲状腺切除术后甲状腺功能恢复中的作用.
- 为了确定影响IOPTH水平的因素.
主要方法:
- 在2018-2019年间对164名接受全甲状腺切除术的患者进行了回顾性分析.
- 甲状腺切除术后15分钟IOPTH测量 (有或没有淋巴结解剖).
- 对IOPTH和ΔPTH%的ROC曲线分析预测低血症和副甲状腺功能恢复.
主要成果:
- IOPTH和ΔPTH%在预测术后低血症方面表现出显著的特异性和敏感性.
- 这些标志物也有效地评估了副甲状腺功能恢复.
- 低IOPTH (<15 pg/mL) 的危险因素包括手术前低PTH,慢性淋巴细胞甲状腺炎和副甲状腺自身移植.
结论:
- IOPTH和ΔPTH%是完全甲状腺切除术后缺血症和副甲状腺功能恢复的可靠预测指标.
- 患有慢性淋巴细胞甲状腺炎,副甲状腺自身移植或手术前低PTH的患者需要密切的术后监测.
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