Measurement of Intact Serum Parathormone and Corrected Serum Calcium after Thyroid Surgery

Sweety Kumari, Rahul Khanna, Neeraj K. Agrawal, Ritika Khanna, R. Meena
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Abstract

Abstract Postoperative hypocalcemia is an important complication of thyroid surgery. The present study was undertaken to measure the serum levels of intact parathormone (iPTH) and corrected serum calcium (CSC) in the immediate postoperative period and then sequentially till 1 month after thyroid surgery. A total of 36 patients undergoing total thyroidectomy and 44 undergoing hemithyroidectomy had measurement of the level of iPTH and CSC at 1 hour, 1 day, 1 week, and 1 month after surgery. A mean drop of 9.3% in CSC, 40% in iPTH, and 10% in ionic calcium levels was noted 1 hour after total thyroidectomy. All the patients recovered to near preoperative levels at the 1-month follow-up. Among hemithyroidectomy patients, significant postsurgery drop in levels was not observed. The importance of the study is early recognition of a hypoparathyroid state at 1 hour after surgery and institution of calcium replacement, thereby sparing the patient from unpleasant symptoms of hypocalcemia. Furthermore, patients with a drop in the iPTH levels below the defined hypoparathyroidism levels should have careful evaluation of their thyroidectomy specimen for identification and possible autotransplantation of the parathyroid gland intraoperatively or in the immediate postoperative time frame.
甲状腺手术后完整血清副激素和校正血清钙的测定
摘要 术后低钙血症是甲状腺手术的一个重要并发症。本研究旨在测量甲状腺手术后1个月内的血清完整副甲状腺激素(iPTH)和校正血清钙(CSC)水平。共有 36 名接受全甲状腺切除术的患者和 44 名接受半甲状腺切除术的患者分别在术后 1 小时、1 天、1 周和 1 个月测量了 iPTH 和 CSC 水平。甲状腺全切除术后1小时,CSC平均下降9.3%,iPTH平均下降40%,离子钙平均下降10%。所有患者在术后1个月的随访中都恢复到了接近术前的水平。在半甲状腺切除术患者中,没有观察到术后水平的显著下降。这项研究的重要意义在于,术后1小时就能及早发现甲状旁腺功能减退状态,并进行钙替代治疗,从而使患者免于低钙血症的不适症状。此外,iPTH水平下降到甲状旁腺功能减退症定义水平以下的患者应仔细评估其甲状腺切除术标本,以便在术中或术后立即进行甲状旁腺的鉴定和自体移植。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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