Zamboni W A, Folse R
Am J Surg. 1986 Dec;152(6):611-5. doi: 10.1016/0002-9610(86)90436-8.
To evaluate the relationship of parathyroid adenoma weight to perioperative serum calcium levels, 51 selected patients with pathologically confirmed single adenomas and minimal biopsy at operation were reviewed. Three age- and sex-matched groups were established according to adenoma weight. Compared with Group 1 patients who had adenomas of less than 1 g, Group 3 patients with adenomas of more than 2 g demonstrated significantly higher preoperative serum parathyroid hormone and calcium levels, and significantly lower preoperative serum phosphate levels. Multiple regression analysis revealed a strong correlation between adenoma weight to preoperative parathyroid hormone and calcium levels (r = 0.63, p less than 0.001). These results suggest that larger adenomas may be associated with a more severe form of primary hyperparathyroidism. The incidence of transient postoperative hypocalcemia in the 51 patients who underwent adenoma excision was 37 percent. Permanent hypoparathyroidism did not develop in any of them. Compared with Group 1 patients, Group 3 patients demonstrated a higher incidence of postoperative transient hypocalcemia (69 percent versus 14 percent in Group 1, p less than 0.001) and significantly lower mean serum calcium levels on the third and fourth postoperative days. Increased adenoma weight may be a valuable aid in identifying those patients at risk for transient hypocalcemia after neck exploration.
为评估甲状旁腺腺瘤重量与围手术期血清钙水平的关系，我们回顾了51例经病理证实为单发腺瘤且术中活检最少的患者。根据腺瘤重量建立了三个年龄和性别匹配的组。与腺瘤重量小于1g的第1组患者相比，腺瘤重量超过2g的第3组患者术前血清甲状旁腺激素和钙水平显著更高，术前血清磷酸盐水平显著更低。多元回归分析显示腺瘤重量与术前甲状旁腺激素和钙水平之间存在强相关性（r = 0.63，p小于0.001）。这些结果表明，较大的腺瘤可能与更严重形式的原发性甲状旁腺功能亢进有关。在接受腺瘤切除的51例患者中，术后短暂性低钙血症的发生率为37%。他们中无一例发生永久性甲状旁腺功能减退。与第1组患者相比，第3组患者术后短暂性低钙血症的发生率更高（第3组为69%，第1组为14%，p小于0.001），且术后第三天和第四天的平均血清钙水平显著更低。腺瘤重量增加可能有助于识别颈部探查术后有短暂性低钙血症风险的患者。
