甲状腺术后引流液甲状旁腺激素测定的意义探索

Significance of parathyroid hormone measurement in drainage liquid after thyroidectomy

目的探讨甲状腺术后患者引流液中的甲状旁腺激素水平与术中甲状旁腺原位保留之间的相关性，评估原位保留的甲状旁腺分泌功能。方法2013年12月至2014年8月于福建医科大学附属协和医院甲状腺外科接受单侧甲状腺叶＋峡部切除术患者166例。根据术中甲状旁腺原位保留0枚、1枚、2枚分为A0、A1和A2组。测定术前、术后血甲状旁腺激素（parathyroid hormone，PTH）、血钙，术后引流液PTH水平。结果术后血唧、血钙均较术前降低（P〈0．05）。术后甲状旁腺A0、A1和A2组之间引流液PTH水平的比较差异有统计学意义（P〈0．05），A2组引流液的PTH值最高，A0组最低。甲状旁腺原位保留数目与引流液的PTH值成正相关关系。结论甲状腺术后引流液PrH的测定可用于判断甲状旁腺是否术中原位保留及其分泌功能的情况。

Objective To explore the significance of parathyroid hormone （PTH） measurement in drainage liquid after thyroid surgery,and to evaluate its relationship with parathyroid glands in situ. Methods Form Dec. 2013 to Aug. 2014, 166 patients who underwent unilateral thyroidectomy were chosen as the research object. Ac- cording to the number of parathyroid reserved in situ, patients were divided into group A0, group A1 and group A2. The levels of blood PTH and serum calcium were measured before and after operation, and postoperative PTH in drainage liquid was measured. Results The levels of postoperative blood PTH and serum calcium were lower than those before operation（P〈0.05）. The difference of PTH level in drainage liquid in each group had sta- tistical significance（P〈0.05）. The level of drainage liquid PTH was highest in group A2, following group A1, and finally group A0. We found a positive correlation between the number of parathyroid glands protected in situ and the level of drainage liquid PTH. Conclusion Drainage liquid PTH measurement can be used to determine whether parathyroid gland is reserved in situ and its secretion function.