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- 저자 : 김호엽 (검색결과 3 건)
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甲狀腺 全切除術 後 低칼슘血症의 豫測因子로서의 副甲狀腺 호르몬
Objective: Hypocalcemia is the most commonly occurring complication after total thyroidectomy. The objective of this study was to determine whether the measurement of i-PTH (intact parathyroid hormone) concentrations in the early postoperative period accurately predicts the patients at risk of developing hypocalcaemia and those that can be safely discharged on the first postoperative day. Methods: A prospective study of patients undergoing total thyroidectomy was conducted. Thirty-eight patients were recruited into the study in the period spanning May 2009 to March 2010. I-PTH concentrations, Ca(calcium), ionized Ca, P(phosphate), and Mg(magnesium) were preoperatively measured, and then at 0 h(hours), 6, 12, 24, 72, and 120 postoperatively. Result: According to the statistical results, post OP(operation) 6 h i-PTH showed the lowest average by Mann-Whitney test. I-PTH in all the time except post OP 0 h was statistically significant by logistic regression test. The odds ratio of post OP 6 h i-PTH was 1.572 (95% CI 1.128-2.191) and the highest level. An i-PTH ≦10.6mg/dl measured at 6 h after surgery had a sensitivity, specificity and positive predictive value of 89, 88 and 85%, respectively, for predicting postoperative hypocalcemic symptoms. Conclusion: Post OP 6 h i-PTH ≦10.6mg/dl allows for the accurate prediction of patients who are at risk of hypocalcemic symptoms. Continuously for more than six months the patient observation of a persistent hypocalcemia, and transient hypocalcemia, normocalcemia can be classified as parathyroid hormone levels, the study will be needed.
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