甲状腺切除术后首日血清钙和甲状旁腺激素水平作为安全出院的预测因素
FIRST DAY SERUM CALCIUM AND PARATHYROID HORMONE LEVELS AS PREDICTIVE FACTORS FOR SAFE DISCHARGE AFTER THYROIDECTOMY.
作者信息
Sala D T, Muresan M, Voidazan S, Cvasciuc T, Darie R, Danielopol V, Muresan S, Pascanu I
机构信息
University of Medicine, Pharmacy, Science and Technology of Targu Mures - Second Department of Surgery, Mures, Romania.
University of Medicine, Pharmacy, Science and Technology of Targu Mures - Epidemiology Department, Mures, Romania.
出版信息
Acta Endocrinol (Buchar). 2019 Apr-Jun;15(2):225-230. doi: 10.4183/aeb.2019.225.
CONTEXT
Permanent hypocalcemia is a rare but significant complication of thyroid surgery.
OBJECTIVE
The aim of this study was to identify predictive factors of hypocalcemia and hypoparathyroidism after thyroidectomy.
DESIGN
Study included 134 total patients submitted to thyroidectomy from two endocrine units (January 2015 - August 2016).
METHODS
We measured total serum calcium (sCa) and intact PTH (iPTH) on postoperative day one and 1 month after surgery.
RESULTS
118 patients were women with F/M ratio of 7.3/1 and a mean age of 51.8 years. 64 patients were included in group A (iPTH <12 pg/mL) and 70 patients in group B (iPTH >12 pg/mL). sCa and hypocalcemia symptoms were correlated with iPTH, measured 24 hours after surgery. The cut-off value was for sCa 8.05 mg/dL with a sensitivity of 85.29% and a specificity of 88.0% and for iPTH 11.2 pg/mL, with a sensitivity of 82.3% and a specificity of 71.0%. SCa (< 8.05 mg/dL) was a predictive factor with a 99 (IC95%:12.86-761.58) and iPTH (<11.2 pg/mL) with a 10.77 higher risk (CI95%: 3.83-30.30) to be associated with symptoms.
CONCLUSION
SCa and iPTH represent good predictive factors of early and safe hospital discharge and can predict the risk of prolonged and permanent hypoparathyroidism.
背景
永久性低钙血症是甲状腺手术罕见但严重的并发症。
目的
本研究旨在确定甲状腺切除术后低钙血症和甲状旁腺功能减退的预测因素。
设计
研究纳入了来自两个内分泌科室的134例行甲状腺切除术的患者（2015年1月至2016年8月）。
方法
我们在术后第1天和术后1个月测量了血清总钙（sCa）和完整甲状旁腺激素（iPTH）。
结果
118例患者为女性，男女比例为7.3/1，平均年龄51.8岁。64例患者纳入A组（iPTH<12 pg/mL），70例患者纳入B组（iPTH>12 pg/mL）。术后24小时测量的sCa和低钙血症症状与iPTH相关。sCa的临界值为8.05 mg/dL，敏感性为85.29%，特异性为88.0%；iPTH的临界值为11.2 pg/mL，敏感性为82.3%，特异性为71.0%。sCa（<8.05 mg/dL）是一个预测因素，与之相关的症状风险高99倍（95%置信区间：12.86 - 761.58），iPTH（<11.2 pg/mL）与之相关的症状风险高10.77倍（95%置信区间：3.83 - 30.30）。
结论
sCa和iPTH是早期安全出院的良好预测因素，并且可以预测长期和永久性甲状旁腺功能减退的风险。
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