Watson R G, van Heerden J A, Grant C S, Klee G G
Surgery. 1984 Dec;96(6):1151-7.
One hundred patients with biochemically proved primary hyperparathyroidism had serum amylase estimations before and after cervical or mediastinal exploration. After operation the patients were monitored for the development of abdominal symptoms suggestive of pancreatitis. Although hyperamylasemia occurred in four patients after operation, clinical acute pancreatitis did not arise. Amylase fractionation confirmed the presence of excessive salivary isoamylase in all four patients. Operation on patients with marginally elevated serum creatinine concentrations, those receiving furosemide, and those undergoing concomitant thyroid operation appeared to increase the likelihood of salivary-based hyperamylasemia; this finding suggested an altered renal handling of amylase in the immediate postoperative period. The results of this prospective study and reviewed reports of additional patients undergoing parathyroidectomy indicate that this operation is unlikely to be complicated by postoperative pancreatitis. The probable risk of both pancreatitis and hyperamylasemia would appear to be no more than that with other nonabdominal surgical procedures.
100例经生化检查证实为原发性甲状旁腺功能亢进的患者在颈部或纵隔探查前后均进行了血清淀粉酶测定。术后对患者进行监测，观察是否出现提示胰腺炎的腹部症状。尽管术后有4例患者出现高淀粉酶血症，但并未发生临床急性胰腺炎。淀粉酶分级分离证实所有4例患者均存在过量的唾液型同工淀粉酶。血清肌酐浓度轻度升高的患者、接受呋塞米治疗的患者以及同时接受甲状腺手术的患者术后发生唾液型高淀粉酶血症的可能性似乎增加；这一发现提示术后短期内肾脏对淀粉酶的处理发生了改变。这项前瞻性研究的结果以及对另外一些接受甲状旁腺切除术患者的报道回顾表明，该手术不太可能并发术后胰腺炎。胰腺炎和高淀粉酶血症的可能风险似乎不超过其他非腹部外科手术。
