摘要
目的初步探讨甲状腺全切除术后血清全段甲状旁腺激素（i PTH）检测结合术区引流液i PTH检测在预测甲状旁腺功能方面的临床意义。方法回顾性分析2013年1月至2013年7月期间解放军总医院普通外科及解放军总医院第一附属医院普通外科收治的50例甲状腺癌患者的临床资料,其中乳头状癌49例,髓样癌1例,所有患者均行甲状腺全切除＋第Ⅵ区淋巴结清扫手术,其中18例加行侧颈区淋巴结清扫术。术区放置负压引流,术前1 d检测患者血清i PTH水平,术后第1、3 d分别检测患者血清及术区引流液中i PTH水平。结果 50例患者术前检测血清i PTH值均在正常范围内。术后第1 d血清i PTH值为（12.85±10.50）ng/L（4.64～13.15 ng/L）,第3 d血清i PTH值为（17.45±11.33）ng/L（7.33～26.50 ng/L）,术后第1 d血清i PTH值与术后第3 d血清i PTH值比较差异无统计学意义（P=0.293）;术后第1 d术区引流液i PTH值为（1 550.29±1 678.18）ng/L（5 000～112 ng/L）,第3 d引流液i PTH值为（566.73±753.99）ng/L（2 065～2.81 ng/L）,术后第1 d引流液i PTH值与术后第3 d引流液i PTH值比较差异也无统计学意义（P=0.060）。结论通过检测术区引流液中的i PTH值并结合血清i PTH值,可以更好地帮助我们预测手术后甲状旁腺的功能情况,对患者预后进行正确的评估。
Objective To discuss the clinical significance of intact parathyroid hormone （iPTH） detection of postoperative serum and surgical drainage in predicting parathyroid function. Methods The clinical data of 50 patients with thyroid cancer performed total thyroidectomy from January 2013 to July 2013 in the PLA General Hospital and the First Affiliated Hospital of PLA General Hospital were analyzed retrospectively. In this cohort, there were 49 pappillary carcinomas and 1 medullary carcinoma. All the patients received total thyroidectomy and VI lymph nodes dissection, and 18 of these patients received neck lymph nodes dissection additionally. The negative pressure drainage was placed in the operated area, and the drained fluid and blood were tested for iPTH level on the first day and the third day postoperatively. Results The preoperative iPTH levels were within the normal range for all the patients. The postoperative serum iPTH level was （12.85±10.50） ng/L （4.64-13. 15 ng/L） and （17.454±11.33） ng/L （7.33-26.50 ng/L） on the first day and the third day, respectively, there was no significant difference of the postoperative serum iPTH levels between the first day and the third day （P=-0. 293）. The postoperative surgical drainage iPTH level was （1 550. 294- 1 678. 18） ng/L （5 000-112 ng/L） and （566. 73±753.99） ng/L （2 065-2.81 ng/L） on the first day and the third day, respectively, there was no significant difference of surgical drainage iPTH between the first day and the third day too （P=0. 060）. Conclusions By detecting the postoperative surgical drainage iPTH level combined with serum iPTH level, it could better predict the function of parathyroid after total thyroidectomy, and correctly assess the prognosis of patients.
出处
《中国普外基础与临床杂志》
CAS
2014年第11期1413-1416,共4页
Chinese Journal of Bases and Clinics In General Surgery
