ABSTRACT
Objective:To investigate the clinical value of intraoperative parathyroid hormone monitoring in operation of patients with secondary hyperparathyroidismï¼SHPTï¼. Method:A retrospective analysis was carried out and enrolledï¼ including 100 primary surgery and 14 second surgery. The data of 100 patients with primary surgery and 14 patients with reoperation were retrospectively analyzed. The criterion, predicting the success of surgery, is that the measured iPTH level declines by more than 80% compared with that before surgery, 20 minutes after the last parathyroid gland removed. Serum calcium, serum phosphorus and iPTH tested pre-and post-operation were statistically analyzed. Result:112 casesï¼98 cases in the first operation and 14 cases in the second operationï¼ were cured by operation and the cure rate is 98.2%. In 109 casesï¼97 cases of first operation and 12 cases of reoperationï¼, the intraoperative determination of parathyroid hormone was up to standard, and the sensitivity of predicting the success of surgery was 97.0% and 85.7%, respectively. Postoperative clinical symptoms such as joint pain and skin itching, etc. were significantly improved or disappeared. Postoperative iPTH, serum calcium and serum phosphorus were significantly different from those before surgery, and the difference was statistically significantï¼P<0.05ï¼. Conclusion:Intraoperative parathyroid hormone monitoring has vital clinical guiding value for SHPT, and can improve the success rate significantly. A more than 80% reduction in iPTH at 20 min after the last parathyroidectomy was a good predictor of successful surgery.
Subject(s)
Hyperparathyroidism, Secondary , Parathyroid Hormone , Calcium , Humans , Parathyroidectomy , Retrospective StudiesABSTRACT
Objective:To investigatethe diagnostic value of three combined imaging studies' preoperative localization for secondary hyperparathyroidism.Method:This study lies on the retrospective analysis about 72 patients with secondary hyperparathyroidism who had parathyroid gland resection in our hospital from 2010 to 2017. All of 72 cases are examined by color doppler ultrasound,99mTC-MIBI nuclide imaging and magnetic resonance imaging. According to the gold standard pathological diagnosis after surgery, we compute the sensitivity and the specificity of various imaging examination and analyse these statistics by rate card square test with SPSS 19.0 software.Result:The parathyroid gland number of pathological diagnosis is 282. The sensitivities of magnetic resonance imaging, 99mTC-MIBI nuclide imaging, color doppler ultrasound and three combined imaging are 72.70%, 47.52%, 44.33% and 82.27%, respectively. The specificities of the examinations are 78.16%, 91.75%, 95.14% and 67.96%, respectively. The sensitivity of the combined three imaging studies is greater than the sensitivity of each single imaging studies, and there is a statistical significance between them. The specificity of the combined three imaging studies is smaller than the sensitivity of single imaging studies. There is a statistical significance,either.Conclusion:Three combined imaging studies' preoperative localization for secondary hyperparathyroidism has higher diagnostic value for the preoperative localization about secondary hyperparathyroidism. It can be a effective way to SHPT's surgery.
