甲状腺全切除术后不同时间PTH水平检测对低钙血症预测效果的评价

发布时间：2018-06-20 20:16

本文选题：甲状旁腺素（PTH） + 血钙浓度　；参考：《吉林大学》2015年硕士论文

【摘要】：目的甲状腺全切术后甲状旁腺功能低下导致临床上出现的低钙血症，经常造成住院时间的延长。本研究通过探讨甲状腺全切术后甲状旁腺素（PTH）的测定，探讨是否能够通过血清中PTH浓度早期预测术后不同时间低钙血症的发生。从而找出一个简单、可靠的判断甲状腺全切术后低钙血症发生的指标，对于判断是否给予钙剂治疗的具有指导意义。方法回顾我院138例甲状腺癌行甲状腺全切除患者，通过对其血清钙离子（Ca2+）和PTH水平在术后1小时、6小时，24小时进行连续测定，计算血清PTH浓度预测低钙血症的特异度，灵敏度，，阴性和阳性预测值，判断根据PTH水平是否能够预测术后24小时低钙血症的发生。结果138例甲状腺全切术后患者术后24小时有36例（26.1%）发生低钙血症（Ca2+＜2.05mmol/l），术后1小时PTH＜15pg/ml的患者在术后24小时发生低钙血症的特异度，灵敏度，阳性和阴性预测值分别为88.9%，100%，96.2%和100%。结论研究发现术后1小时PTH水平能早期预测的甲状腺全切除术后24小时有低钙血症的发生。并可以早期对患者进行钙剂及骨化三醇等治疗，避免发生严重低钙血症的风险。另一方面早期低钙血症的患者PTH在正常范围内的甲状腺全切患者可避免过度补钙，避免了钙剂的过度治疗。
[Abstract]:Objective hypoparathyroidism after total thyroidectomy leads to hypocalcemia, which often results in prolonged hospital stay. In this study, we investigated the determination of parathyroid hormone (PTH) after total thyroidectomy, and explored whether serum PTH concentration could predict hypocalcemia at different times after thyroidectomy. Therefore, a simple and reliable index of hypocalcemia after total thyroidectomy is found, which is of guiding significance in judging whether to give calcium therapy or not. Methods 138 patients with thyroid cancer undergoing total thyroidectomy were reviewed. Serum Ca 2 + Ca 2 + and PTH levels were determined continuously at 1 hour and 6 hours after operation and 24 hours after operation. The specificity of serum PTH concentration in predicting hypocalcemia was calculated. Sensitivity, negative and positive predictive values to determine whether PTH level can predict the occurrence of hypocalcemia 24 hours after operation. Results there were 36 cases with hypocalcemia (Ca 2 < 2.05 mmol / L) at 24 hours after total thyroidectomy. The specificity, sensitivity, positive and negative predictive values of hypocalcemia were 96.2% and 100% respectively in patients with PTH < 15pg/ml at 24 hours after thyroidectomy. Conclusion hypocalcemia occurred 24 hours after thyroidectomy with PTH level 1 hour after operation. The patients can be treated with calcium and calcitriol early to avoid the risk of severe hypocalcemia. On the other hand, PTH patients with early hypocalcemia in the normal range of total thyroidectomy can avoid excessive calcium supplementation and calcium overtreatment.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R653

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