滨州医学院学报
濱州醫學院學報
빈주의학원학보
JOURNAL OF BINZHOU MEDICAL COLLEGE
2015年
4期
257-259
,共3页
艾向南%金昌国%欧阳才国%孙鹏超%胡浩
艾嚮南%金昌國%歐暘纔國%孫鵬超%鬍浩
애향남%금창국%구양재국%손붕초%호호
慢性肾衰%甲状旁腺功能亢进%甲状旁腺切除%低钙血症
慢性腎衰%甲狀徬腺功能亢進%甲狀徬腺切除%低鈣血癥
만성신쇠%갑상방선공능항진%갑상방선절제%저개혈증
chronic renal failure%hyperparathyroidism%parathyroidectomy%hypocalcemia
目的:探讨继发性甲状旁腺功能亢进(SHPT)患者甲状旁腺切除术后重度低钙血症(SHC)相关因素,进而建立SHC防治策略。方法回顾性分析2012年3月—2014年5月在我院行甲状旁腺切除治疗的S H P T病例资料。行单因素及多因素分析明确S HC的独立影响因素,确定定量因素界值。结果共收集88例病例资料,术后发生S HC46例(52.3%)。单因素分析显示年龄、ALP、iPTH、切除的甲状旁腺数(RTPN)具有统计学显著差异,多因素分析显示年龄、iPTH、RTPN≥4为SHC的独立影响因素,确定的界值为年龄48岁(PPV68.8%,NPV67.5%)和iPT H 1750 pg/ml(PPV85.4%,NPV87.5%)。结论年龄、甲状旁腺激素水平、甲状旁腺切除数量为SHPT患者甲状旁腺切除术后SHC的独立影响因素。选择性地对高危患者实施静脉补钙,选择合理的手术方式,可作为防治S HC的初步策略。
目的:探討繼髮性甲狀徬腺功能亢進(SHPT)患者甲狀徬腺切除術後重度低鈣血癥(SHC)相關因素,進而建立SHC防治策略。方法迴顧性分析2012年3月—2014年5月在我院行甲狀徬腺切除治療的S H P T病例資料。行單因素及多因素分析明確S HC的獨立影響因素,確定定量因素界值。結果共收集88例病例資料,術後髮生S HC46例(52.3%)。單因素分析顯示年齡、ALP、iPTH、切除的甲狀徬腺數(RTPN)具有統計學顯著差異,多因素分析顯示年齡、iPTH、RTPN≥4為SHC的獨立影響因素,確定的界值為年齡48歲(PPV68.8%,NPV67.5%)和iPT H 1750 pg/ml(PPV85.4%,NPV87.5%)。結論年齡、甲狀徬腺激素水平、甲狀徬腺切除數量為SHPT患者甲狀徬腺切除術後SHC的獨立影響因素。選擇性地對高危患者實施靜脈補鈣,選擇閤理的手術方式,可作為防治S HC的初步策略。
목적:탐토계발성갑상방선공능항진(SHPT)환자갑상방선절제술후중도저개혈증(SHC)상관인소,진이건립SHC방치책략。방법회고성분석2012년3월—2014년5월재아원행갑상방선절제치료적S H P T병례자료。행단인소급다인소분석명학S HC적독립영향인소,학정정량인소계치。결과공수집88례병례자료,술후발생S HC46례(52.3%)。단인소분석현시년령、ALP、iPTH、절제적갑상방선수(RTPN)구유통계학현저차이,다인소분석현시년령、iPTH、RTPN≥4위SHC적독립영향인소,학정적계치위년령48세(PPV68.8%,NPV67.5%)화iPT H 1750 pg/ml(PPV85.4%,NPV87.5%)。결론년령、갑상방선격소수평、갑상방선절제수량위SHPT환자갑상방선절제술후SHC적독립영향인소。선택성지대고위환자실시정맥보개,선택합리적수술방식,가작위방치S HC적초보책략。
Objective To explore the factors associated with severe hypocalcemia(SHC) after parathyroidectomy for seconda‐ry hyperparathyroidism(SHPT) patients ,and to establish a strategy for the prevention and treatment of SHC .Methods A ret‐rospective study of clinical data was conducted in the cases of SHPT undergone parathyroidectomy in our hospital from Mar 2012 to May 2014 .Uni‐and multivariate analysis was conducted to define independent influence factors for the SHC ,and the cut‐off values of quantitative factors were defined .Results Eighty‐eight cases of clinical data were collected and the SHC was shown in 46 cases(52.3% ) after operation .Univariate analysis showed that age ,ALP ,iPTH and the resected parathyroid gland number(RTPN)emerged statistically significant difference ,and multivariate analysis showed that age ,iPTH and RTPN ≥4 were the independent influence factors for the SHC individually .The defined cut‐off values of age and iPTH were 48y (PPV68.8% ,NPV67.5% )and 1 750 pg/ml(PPV85.4% ,NPV87.5% ) ,respectively .Conclusion Age ,PT H level and the RT‐PN are the independent influence factors for the SHC after parathyroidectomy in SHPT patients .Selective intravenous supple‐mentation of calcium for the patients at high risk and selection of reasonable surgical manner can be established as preparatory strategy for the prevention and treatment of the SHC .