本文選題：甲狀旁腺激素 + 全甲狀腺切除��； 參考：《青海大學(xué)》2015年碩士論文

【摘要】：目的:分析全甲狀腺切除術(shù)后患者的血鈣及甲狀旁腺激素的變化規(guī)律及術(shù)后第一天甲狀旁腺激素預(yù)測低鈣血癥的價(jià)值。方法:選取青海大學(xué)附屬醫(yī)院乳腺甲狀腺外科2013.6至2014.6期間行全甲狀腺切除的患者100例,所有患者擬行手術(shù)前均未接受有關(guān)補(bǔ)鈣治療,術(shù)前及術(shù)后第1天清晨空腹檢測PTH及血鈣值,術(shù)后第2、3、5天繼續(xù)檢測血鈣值,術(shù)后仔細(xì)觀察患者出現(xiàn)的癥狀及表現(xiàn),并及時(shí)記錄。結(jié)果:100例患者,低鈣的發(fā)生率為68%,其中出現(xiàn)癥狀為46%,術(shù)后第2天血鈣最低[(1.86±0.14)mmol/L];低血鈣患者術(shù)后第1天PTH[(14.03±6.01)pg/ml]低于血鈣正常的患者[(29.31±12.33)pg/ml],且差異具有統(tǒng)計(jì)學(xué)意義(p0.001);術(shù)后第1天PTH值15 pg/ml更易出現(xiàn)低鈣血癥(p0.05);術(shù)后第1天PTH值15.85 pg/ml預(yù)測低鈣癥狀出現(xiàn)的敏感性為72.2%,特異性為89.1%。結(jié)論:全甲狀腺切除術(shù)后第1天PTH值可以預(yù)測術(shù)后低鈣癥狀的出現(xiàn),但其特異性和敏感性不是很高;術(shù)后低血鈣與PTH值的降低有關(guān)聯(lián)性;術(shù)后補(bǔ)鈣可以阻止血鈣的進(jìn)一步降低。
[Abstract]:Objective: to analyze the changes of serum calcium and parathyroid hormone after total thyroidectomy and the value of parathyroid hormone in predicting hypocalcemia on the first day after thyroidectomy.Methods: 100 patients who underwent total thyroidectomy from 2013.6 to 2014.6 in the Department of Breast thyroid surgery, affiliated Hospital of Qinghai University, were selected.PTH and serum calcium were measured before operation and the first day after operation on an empty stomach. The serum calcium values were continuously measured on the 2nd day and 3th day after operation. The symptoms and manifestations of the patients were observed carefully and recorded in time.Results one hundred patients,The incidence of hypocalcemia was 68. The incidence of hypocalcemia was 46 and the second day after operation it was the lowest [1.86 鹵0.14)mmol/L]. The PTH of hypocalcemia patients on the first day after operation was lower than that of patients with normal serum calcium [29.31 鹵12.33)pg/ml], and the difference was statistically significant, and the PTH value of 15 pg/ml on the first day after operation was more easily found.On the first day after operation, the sensitivity of PTH 15.85 pg/ml to predict the occurrence of hypocalcemia was 72.2 and the specificity was 89.1.Conclusion: PTH on the first day after total thyroidectomy can predict the occurrence of hypocalcemia, but its specificity and sensitivity are not very high, hypocalcemia is associated with the decrease of PTH, and calcium supplementation after operation can prevent the further decrease of serum calcium.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R653

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