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題 名 | 保留一顆有血液供應的副甲狀腺患者之血鈣離子變化=Free Calcium Levels in Patients with a Single Vascularized Parathyroid Gland |
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作 者 | 江豐裕; | 書刊名 | 中華民國耳鼻喉科醫學雜誌 |
卷 期 | 34:3 民88.05-06 |
頁 次 | 頁179-183 |
分類號 | 416.214 |
關鍵詞 | 甲狀腺手術; 血鈣離子濃度; 副甲狀腺自體移植; Thyroid surgery; Free calcium level; Parathyroid autotransplantation; |
語 文 | 中文(Chinese) |
中文摘要 | 背景:大多學者都認同病人接受甲狀腺手術後,2顆有功能的副甲狀腺便能維持正 常的血鈣離子濃度,但人體若僅存1顆副甲狀腺時,血鈣離子的變化便較少人研究。本研究 的目的在企圖了解人體若只剩1顆血液供應完整的副甲狀腺時,是否尚能維持正常的血鈣離 子濃度。我們希望發展出一種適當的手術技巧來保留副甲狀腺的功能,並減少在施行甲狀腺 全切除術時發生暫時性或永久性低血鈣症的機率。 方法:從1996年1月至1997年6月間,我們收集50例因甲狀腺結節接受單側全葉切除 術的病人分成A、B兩組。A組25例病人接受3顆副甲狀腺自體移植,B組25例病人接受0-2 顆副甲狀腺自體移植。術前至術後至少6天所有的病人都接受血鈣離子的偵測。 結果:A組病人平均血鈣離子濃度在術後第2天和第3天顯示有意表的下降,術後第4天 便開始回升,在5至6天便恢復到正常。B組病人術前與術後任何1天的平均血鈣離子均無 有意義的差別。 結論:從此研究可知人體若僅存1顆有血液供應的副甲狀腺時,大多數的病人尚能維持正 常的血鈣離子濃度,雖然有些病人發生暫時性低血鈣症,但都能在5天內恢復到正常值。 |
英文摘要 | Background: It is well accepted that 2 parathyroid glands are sufficient to maintain a normal free calcium level after thyroid surgery, but the variations of free calcium levels in patients having only one vascularized parathyroid are not well understood. The purpose of this study was trying to understand the variation of free calcium level in patients who underwent auto-transplantation of 3 parathyroid glands and have only one parathyroid gland preserved with intact blood supply. We hope to develop an optimal surgical approach to preserve the function of parathyroid glands and decrease the rate of permanent and temporary hypocalcemia after total thyroidectomy. Methods: From January 1, 1996 to June 30, 1997, 50 patients underwent unilateral total lobectomy due to solitary thyroid nodule. Twenty-five patients (group A) had 3 parathyroid glands removed and auto-transplanted, and 25 patients (group B) had 0 to 2 parathyroid glands removed and auto-transplanted. Results: Free calcium levels were measured preoperatively and daily for at least 6 days postoperatively. The mean free calcium value of group A patients decreased significantly on postoperative day 2 and 3, but returned to normal within 5 to 6 days. In group B patients, preoperative and postoperative mean free calcium values were essentially unchanged. Conclusions: From this study, we conclude that most patients with only one well vascularized parathyroid gland preserved would be sufficient to maintain free calcium levels, although some of the patients experienced transient hypocalcemia for a few days. |
本系統中英文摘要資訊取自各篇刊載內容。