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地塞米松治疗对全甲状腺切除术后短暂性甲状旁腺功能减退的预防作用

Preventive Effect of Dexamethasone Therapy on the Transient Hypoparathyroidism through Total Thyroidectomy.

作者信息

Kolahdouzan Mohsen, Iraj Bijan, Eslamian Mohammad, Harandizadeh Mohammad, Meamar Rokhsareh

机构信息

Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Iran J Otorhinolaryngol. 2019 Mar;31(103):73-80.

Abstract

INTRODUCTION

This study aimed to investigate whether pre-operative dexamethasone could ameliorate transient hypoparathyroidism outcome through total thyroidectomy.

MATERIALS AND METHODS

This randomized clinical trial study was conducted on 128 patients underwent total thyroidectomy from March 2014 to April 2015. Patients were randomly assigned to two groups of experimental receiving 8 mg IV of intravenous dexamethasone (n=45) 45 min before skin incision treatment and control (n=83). After the surgery, all patients were evaluated for clinical and laboratory hypocalcaemia.

RESULTS

Post-operative transient biochemical hypoparathyroidism and hypocalcaemia did not occur more often in the control group, compared to the dexamethasone group while controlling for the baseline variables. However, there was a significant difference in phosphorus level between the dexamethasone and control groups (P=0.028). A total of 50 (39.1%) patients developed hypocalcaemia after surgery. Moreover, post-operative symptomatic hypocalcemia occurred more frequently in the control group (68%) compared to the dexamethasone group (32%); however, this difference was not statistically significant (P=0.54).

CONCLUSION

The pre-operative administration of dexamethasone reduced post-operative hypocalcemia rate. It is essential to conduct future studies with validated means for better results.

摘要

引言

本研究旨在调查术前使用地塞米松是否可通过全甲状腺切除术改善短暂性甲状旁腺功能减退的结局。

材料与方法

本随机临床试验研究于2014年3月至2015年4月对128例行全甲状腺切除术的患者进行。患者被随机分为两组,试验组在皮肤切开前45分钟静脉注射8毫克地塞米松(n = 45),对照组(n = 83)。术后,对所有患者进行临床和实验室低钙血症评估。

结果

在控制基线变量的情况下,与地塞米松组相比,对照组术后短暂性生化甲状旁腺功能减退和低钙血症的发生率并未更高。然而,地塞米松组和对照组之间的磷水平存在显著差异(P = 0.028)。共有50名(39.1%)患者术后发生低钙血症。此外,对照组术后症状性低钙血症的发生率(68%)高于地塞米松组(32%);然而,这种差异无统计学意义(P = 0.54)。

结论

术前给予地塞米松可降低术后低钙血症发生率。有必要进行未来研究以采用有效方法获得更好结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd52/6449529/b418c0b6a3fb/ijo-31-073-g001.jpg

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