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Clinical Research of Prophylactic Calcium Supplementation in Patients after Total-thyroidectomy

Author: ChenHuiBin
Tutor: ChengRuoChuan
School: Kunming Medical College
Course: Surgery
Keywords: Parathyroid Hypoparathyroidism Hypocalcemia Prophylactic calcium Thyroid surgery
CLC: R653
Type: Master's thesis
Year: 2011
Downloads: 48
Quote: 0
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Abstract


Objective To postoperative prophylactic total thyroidectomy calcium treatment, investigate postoperative prophylactic calcium supplementation on thyroid parathyroid function recovery. Method: 1, 232 patients met the inclusion criteria in order first by surgery parity is divided into A (prophylactic calcium group) and group B (non-prophylactic calcium group), according to the lowest in three days after the day parathyroid gonadotropin (parathyroid hormone, PTH) values, A, B is further divided into two groups A1 (PTH ≥ 8pg/ml) and A2 (PTH lt; 8pg/ml); B1 (PTH ≥ 8pg/ml) and B2 (PTH lt ; 8pg/ml). All patients in group A were treated with intravenous calcium 6g / d, B group of patients not being given calcium, postoperative hypocalcemia or hypocalcemia but test results PTH lt; 8pg/ml give intravenous calcium 6g / d. 2, C group was the control group (20 in our department unilateral inguinal hernia repair surgery). 3, ① A1, B1 groups detected preoperatively and postoperatively 1,2,3,7 days and January calcium and PTH levels and record clinical manifestations of hypocalcemia. ② A2, B2 detect 1,2,3,7 preoperative and postoperative days, one week, two weeks, three weeks, and in January PTH and calcium levels and record clinical manifestations of hypocalcemia by hypocalcemia The clinical manifestations of a simple score. Results: 1 (a) on postoperative day 1 A1, B1 groups PTH and serum calcium levels decreased compared with the preoperative, the first two days to a minimum, then gradually increased. calcium levels higher than the B1 group [A1/B1 was (2.12 ± 0.09) / (2.09 ± 0.08) mmol / L, P lt; 0.05]. Group B1 [A1/B1 was (2.09 ± 0.13) / (2.04 ± 0.11) mmol / L, P lt; 0.05]. after the first three days: A1 and B1 group PTH group difference was not statistically significant [A1/B1 P lt; 0.05]. 7th day: A1 group was significantly higher than that in group B1 PTH significantly [A1/B1 was (28.08 ± 8.61) / (25.41 ± 8.27) pg / ml, P lt; 0.05]; A1 group of high calcium in group B1 [A1/B1 was (2.27 ± 0.10) / (.2.24 ± 0.06) mmol / L, P lt; 0.05)]. the difference was not statistically significant [A1/B1 was (2.35 ± 0.09) / (2.34 ± 0.08) mmol / L, P gt; 0.05]. A1 group had 26 (29.9%) hypocalcemia, 2 cases (2.3%) occurred hypocalcemia; B1 group, 39 (47%) cases of hypocalcemia, 8 cases (9.7%) appeared hypocalcemia disease, Al group hypocalcemia and the incidence of hypocalcemia was significantly lower than in group B1 (P lt; 0.05). 2 (a) on postoperative day 1 A2, B2 and PTH groups compared with preoperative serum calcium levels decreased to a minimum of two days, then gradually increased. (2) ① 1,2,3 days after the first A2, B2 PTH levels two groups no significant difference (P gt; 0.05), after the first one week, two weeks, three weeks PTH levels higher than group A2 B2 group (P lt; 0.05); A2 B2 group group PTH PTH compared to first restore the normal range. ② from postoperative day 1 to 3 weeks after serum calcium levels higher than group A2 B2 group (P lt; 0.05), after 1 month no significant difference between two groups of serum calcium levels (P gt; 0.05); A2 group serum calcium levels than B2 group was first restored to the normal range. ③ A2 group, 22 patients (73.3%) occurred hypocalcemia, 16 cases (53.3%) hypocalcemia, B2 group of 30 patients (93.7%) occurred hypocalcemia, 25 cases (78.1%) hypocalcemia, Group A2 hypocalcemia and the incidence of hypocalcemia was significantly less than the B2 group (P lt; 0.05). (3) hypocalcemia Rating: 1,2,3 postoperative day, 1 week group B2 hypocalcemia score was significantly higher than the group A2 (P lt; 0.05). Conclusion prophylactic total thyroidectomy in favor parathyroid calcium (parathyroid glands, PTG) functional recovery, and hypocalcemia can effectively reduce the incidence of hypocalcemia, hypercalcemia and hypocalcemia low shorten recovery time reduce the clinical manifestations of hypocalcemia, treatment and prevention of low calcium on the physical and psychological effects in patients.

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