甲状腺围术期甲状旁腺素与术后低钙血症的关系

目的探讨甲状腺围术期血清甲状旁腺素(PTH)的变化规律及其与甲状腺术后低钙血症(PHC)的相关关系。方法 2007年1月至2008年6月甲状腺手术患者322例,分别于术前1d、术中切除腺体后15min、术后第1天、术后第4天测定血清PTH及血清钙。结果甲状腺术后PTH比术前明显下降;PHC组的术中PTH明显低于正常血钙组的术中PTH;术中PTH低于正常值下限的患者PHC的发生率高于术中PTH正常的患者,差异均有统计学意义。结论甲状腺手术会影响甲状旁腺分泌PTH水平,术中PTH低于正常值下限可作为早期预测PHC的重要指标。

Relationship between parathyroid hormone assayed in peri-operation of thyroidectomy and postthyroidectomy hypocalcemia

Objective To investigate the variation of parathyroid hormone（PTH） and the relationship between PTH and postthyroidectomy hypocalcemia （PHC） in peri-operation of thyroidectomy.Methods The clinical data of 322 cases performed thyroidectomy between January 2007 and June 2008 were analyzed.PTH and serum calcium level were assayed 1 day before,during,1day after and 4 days after thyroidectomy.Results PTH level after thyroidectomy reduced significantly in contrast ofthat before operation.PTH level during operation of PHC group was lower significantly than that of normal calcium group.The morbidity of PHC of patients with PTH level during operation less than normal was higher significantly than that of patients with normal PTH level.Conclusions Secretion of parathyroid gland is affected by thyroidectomy and it may make PTH level change.It is an important proof for predicting PHC early when PTH level during operation was less than normal.