全甲状腺切除术后血钙、PTH变化分析及临床意义

发布时间：2018-04-12 10:41

本文选题：甲状旁腺激素 + 全甲状腺切除　；参考：《青海大学》2015年硕士论文

【摘要】：目的:分析全甲状腺切除术后患者的血钙及甲状旁腺激素的变化规律及术后第一天甲状旁腺激素预测低钙血症的价值。方法:选取青海大学附属医院乳腺甲状腺外科2013.6至2014.6期间行全甲状腺切除的患者100例,所有患者拟行手术前均未接受有关补钙治疗,术前及术后第1天清晨空腹检测PTH及血钙值,术后第2、3、5天继续检测血钙值,术后仔细观察患者出现的症状及表现,并及时记录。结果:100例患者,低钙的发生率为68%,其中出现症状为46%,术后第2天血钙最低[(1.86±0.14)mmol/L];低血钙患者术后第1天PTH[(14.03±6.01)pg/ml]低于血钙正常的患者[(29.31±12.33)pg/ml],且差异具有统计学意义(p0.001);术后第1天PTH值15 pg/ml更易出现低钙血症(p0.05);术后第1天PTH值15.85 pg/ml预测低钙症状出现的敏感性为72.2%,特异性为89.1%。结论:全甲状腺切除术后第1天PTH值可以预测术后低钙症状的出现,但其特异性和敏感性不是很高;术后低血钙与PTH值的降低有关联性;术后补钙可以阻止血钙的进一步降低。
[Abstract]:Objective: to analyze the changes of serum calcium and parathyroid hormone after total thyroidectomy and the value of parathyroid hormone in predicting hypocalcemia on the first day after thyroidectomy.Methods: 100 patients who underwent total thyroidectomy from 2013.6 to 2014.6 in the Department of Breast thyroid surgery, affiliated Hospital of Qinghai University, were selected.PTH and serum calcium were measured before operation and the first day after operation on an empty stomach. The serum calcium values were continuously measured on the 2nd day and 3th day after operation. The symptoms and manifestations of the patients were observed carefully and recorded in time.Results one hundred patients,The incidence of hypocalcemia was 68. The incidence of hypocalcemia was 46 and the second day after operation it was the lowest [1.86 卤0.14)mmol/L]. The PTH of hypocalcemia patients on the first day after operation was lower than that of patients with normal serum calcium [29.31 卤12.33)pg/ml], and the difference was statistically significant, and the PTH value of 15 pg/ml on the first day after operation was more easily found.On the first day after operation, the sensitivity of PTH 15.85 pg/ml to predict the occurrence of hypocalcemia was 72.2 and the specificity was 89.1.Conclusion: PTH on the first day after total thyroidectomy can predict the occurrence of hypocalcemia, but its specificity and sensitivity are not very high, hypocalcemia is associated with the decrease of PTH, and calcium supplementation after operation can prevent the further decrease of serum calcium.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R653

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