Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Head Neck. 2011 Dec;33(12):1754-7. doi: 10.1002/hed.21666. Epub 2011 Jan 14.
The value of intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy has been previously debated.
This retrospective analysis was of 240 patients, operated on for primary hyperparathyroidism (PHPT) between January 2002 and January 2006 and categorized into 3 groups by preoperative and intraoperative modalities: group 1 (n = 109), technetium 99m sestamibi (MIBI), ultrasonography, and IOPTH; group 2 (n = 102), ultrasonography and MIBI; and group 3 (n = 29), ultrasonography and IOPTH. Sensitivity and specificity were calculated.
In group 1, IOPTH increased the success rate from 97% to 99%. In group 2, ultrasonography and MIBI were concordant in 95% of cases. In group 3, IOPTH increased the sensitivity from 89% to 96%. The duration of surgery was longer (p < .0001) when IOPTH was applied.
When ultrasonography and MIBI are used, the additional benefit of IOPTH is marginal, especially given the longer duration of surgery. Ultrasonography and additional IOPTH yield good success rates when MIBI is not available.
甲状旁腺切除术术中甲状旁腺激素（IOPTH）监测的价值此前存在争议。
这是一项回顾性分析，纳入了 240 例于 2002 年 1 月至 2006 年 1 月期间因原发性甲状旁腺功能亢进症（PHPT）接受手术的患者，根据术前和术中的检查方法将其分为 3 组：组 1（n = 109），锝 99m sestamibi（MIBI）、超声和 IOPTH；组 2（n = 102），超声和 MIBI；组 3（n = 29），超声和 IOPTH。计算了敏感性和特异性。
在组 1 中，IOPTH 将成功率从 97%提高到 99%。在组 2 中，超声和 MIBI 在 95%的病例中一致。在组 3 中，IOPTH 将敏感性从 89%提高到 96%。当应用 IOPTH 时，手术时间延长（p<0.0001）。
当使用超声和 MIBI 时，IOPTH 的额外益处微不足道，尤其是考虑到手术时间延长。当 MIBI 不可用时，超声和额外的 IOPTH 可获得良好的成功率。
