부갑상선 호르몬 측정을 이용한 갑상선 전절제술 후저칼슘혈증의 조기 예측

정한신; 백정한; 김준호; 정규환; 김민범; 손영익

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자료유형: 학술저널

저자정보: 정한신 백정한 김준호 정규환 김민범 손영익

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제49권 제7호

발행연도: 2006.1

수록면: 717 - 722 (6page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

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Background and Objectives：Parathyroid dysfunction following a total or completion thyroidectomy is not uncommon and it may be associated with significant patient morbidity. If there is a simple test with proven high predictability for identifying which patients will develop hypocalcemia, it would be very useful to determine the necessities of careful monitoring and calcium replacement. The purpose of this study is to determine which test would be the most valuable predictor of post-thyroidectomy hypocalcemia. Subjects and Method：Prospective series of 63 consecutive patients undergoing total or completion thyroidectomy were enrolled for this study. Calcium and ionized calcium were measured before and immediately after surgery, and daily during hospitalization. Parathyroid hormone (PTH) was measured immediately after surgery and early in the morning of the next day. Slopes of serum calcium, ionized calcium and PTH level change were calculated. Sensitivity, specificity and predictive values of each test for the symptomatic and biochemical hypocalcemia were compared. Results：With the cut-off value of 10 pg/ml of spot PTH, sensitivity, specificity, positive and negative predictive values of hypocalcemia were 97%, 64%, 77% and 95% respectively. By combining the spot PTH and the slope of ionized calcium change, the above values became 94%, 82%,87% and 92%. Conclusion：Immediate postoperative spot PTH level was the most valuable single test for predicting postthyroidectomy hypocalcemia. Combination of a spot PTH and the slope of ionized calcium change resulted in improved specificity and positive predictability. (Korean J Otolaryngol 2006;49:717-22)

#저칼슘혈증·부갑상선 호르몬·갑상선 절제술·조기 진단·수술 후 합병증. #Hypocalcemia·Parathyroid hormone·Thyroidectomy·Early diagnosis·Postoperative complications.

참고문헌 (15)

참고문헌 신청

/ 1980 / Medical complications of thyroid surgery 13 : 99 ~ 107

/ 1992 / Hypocalcemia after thyroidectomy 127 : 854 ~ 8

/ 1994 / Oral calcium supplements to enhance early hospitaldischarge after bilateral surgical treatment of the thyroid gland orexploration of the parathyroid glands 178 : 11

/ 1995 / Evaluation of total/near-total thyroidectomyin a short-stay hospitalization: Safe and cost-effective. 118 : 943 ~ 947

/ 1995 / Safety of thyroidectomy in residency:A review of 186 consecutive cases 105 : 1173 ~ 1175

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