本文選題：甲狀旁腺素（PTH） + 血鈣濃度　； 參考：《吉林大學(xué)》2015年碩士論文

【摘要】：目的甲狀腺全切術(shù)后甲狀旁腺功能低下導(dǎo)致臨床上出現(xiàn)的低鈣血癥，經(jīng)常造成住院時(shí)間的延長。本研究通過探討甲狀腺全切術(shù)后甲狀旁腺素（PTH）的測定，探討是否能夠通過血清中PTH濃度早期預(yù)測術(shù)后不同時(shí)間低鈣血癥的發(fā)生。從而找出一個(gè)簡單、可靠的判斷甲狀腺全切術(shù)后低鈣血癥發(fā)生的指標(biāo)，對(duì)于判斷是否給予鈣劑治療的具有指導(dǎo)意義。 方法回顧我院138例甲狀腺癌行甲狀腺全切除患者，通過對(duì)其血清鈣離子（Ca2+）和PTH水平在術(shù)后1小時(shí)、6小時(shí)，24小時(shí)進(jìn)行連續(xù)測定，計(jì)算血清PTH濃度預(yù)測低鈣血癥的特異度，靈敏度，，陰性和陽性預(yù)測值，判斷根據(jù)PTH水平是否能夠預(yù)測術(shù)后24小時(shí)低鈣血癥的發(fā)生。 結(jié)果138例甲狀腺全切術(shù)后患者術(shù)后24小時(shí)有36例（26.1%）發(fā)生低鈣血癥（Ca2+＜2.05mmol/l），術(shù)后1小時(shí)PTH＜15pg/ml的患者在術(shù)后24小時(shí)發(fā)生低鈣血癥的特異度，靈敏度，陽性和陰性預(yù)測值分別為88.9%，100%，96.2%和100%。 結(jié)論研究發(fā)現(xiàn)術(shù)后1小時(shí)PTH水平能早期預(yù)測的甲狀腺全切除術(shù)后24小時(shí)有低鈣血癥的發(fā)生。并可以早期對(duì)患者進(jìn)行鈣劑及骨化三醇等治療，避免發(fā)生嚴(yán)重低鈣血癥的風(fēng)險(xiǎn)。另一方面早期低鈣血癥的患者PTH在正常范圍內(nèi)的甲狀腺全切患者可避免過度補(bǔ)鈣，避免了鈣劑的過度治療。
[Abstract]:Objective hypoparathyroidism after total thyroidectomy leads to hypocalcemia, which often results in prolonged hospital stay. In this study, we investigated the determination of parathyroid hormone (PTH) after total thyroidectomy, and explored whether serum PTH concentration could predict hypocalcemia at different times after thyroidectomy. Therefore, a simple and reliable index of hypocalcemia after total thyroidectomy is found, which is of guiding significance in judging whether to give calcium therapy or not. Methods 138 patients with thyroid cancer undergoing total thyroidectomy were reviewed. Serum Ca 2 + Ca 2 + and PTH levels were determined continuously at 1 hour and 6 hours after operation and 24 hours after operation. The specificity of serum PTH concentration in predicting hypocalcemia was calculated. Sensitivity, negative and positive predictive values to determine whether PTH level can predict the occurrence of hypocalcemia 24 hours after operation. Results there were 36 cases with hypocalcemia (Ca 2 < 2.05 mmol / L) at 24 hours after total thyroidectomy. The specificity, sensitivity, positive and negative predictive values of hypocalcemia were 96.2% and 100% respectively in patients with PTH < 15pg/ml at 24 hours after thyroidectomy. Conclusion hypocalcemia occurred 24 hours after thyroidectomy with PTH level 1 hour after operation. The patients can be treated with calcium and calcitriol early to avoid the risk of severe hypocalcemia. On the other hand, PTH patients with early hypocalcemia in the normal range of total thyroidectomy can avoid excessive calcium supplementation and calcium overtreatment.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R653

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 黃韜;;甲狀旁腺術(shù)中損傷的預(yù)防和處理[J];中國實(shí)用外科雜志;2008年03期

2 陳曦;;甲狀腺手術(shù)中甲狀旁腺功能的保護(hù)[J];中國實(shí)用外科雜志;2010年10期

3 閆利英;趙瑞敏;施秉銀;;甲狀腺術(shù)中快速甲狀旁腺激素測定對(duì)預(yù)測術(shù)后低鈣血癥發(fā)生危險(xiǎn)性的研究進(jìn)展[J];中華耳鼻咽喉頭頸外科雜志;2006年06期

4 鄭澤霖;孫輝;蓋寶東;;甲狀腺疾病外科治療的熱點(diǎn)和難點(diǎn)[J];中國普外基礎(chǔ)與臨床雜志;2008年05期

5 孫可望;雷科鋒;姜蔚;;甲狀腺術(shù)后低鈣血癥的預(yù)測與防治[J];浙江預(yù)防醫(yī)學(xué);2010年10期

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