Specific Features of Postoperative Rehabilitation of Patients with Secondary Hyperparathyroidism After Parathyroid Surgery Intervention

Abstract

Aim: The objective of the research is to assess the effectiveness of postoperative rehabilitation of patients with secondary hyperparathyroidism (SHPT) after parathyroid surgery intervention (PTSI). Materials and Methods: The research focused on 143 patients with SHPT after PTSI who experienced chronic renal failure and were on programmed hemodialysis, the ASA risk III-IV. PTSI was performed under general anesthesia. After surgery, group I patients (n=71) received a “potassium-free” diet, programmed hemodialysis, calcium preparations, prophylactic doses of heparins, and symptomatic treatment. In group II (n=72), rehabilitation measures were supplemented with the administration of glucocorticoids with the control of blood cortisol and metabolism. Results: After PTSI, all patients felt general weakness, had a low level of ionized blood calcium, hemodynamic, oxygen and metabolism disorders, with more pronounced manifestations in group I. In group II, synchronously with the reduction of metabolic disorders, hemodynamics and oxygen level were restored to reference values, and hypocalcemia was quickly corrected with administering calcium (≥2g/day). Conclusions: The use of glucocorticoids accompanied with the control of blood cortisol levels and indirect calorimetry during the rehabilitation of patients with SHPT after PTSI accelerates the recovery of life support functions of patients and improves the results of their rehabilitation.