Clinical significance of monitoring drainage fluid parathyroid hormone after thyroid surgery

Lixin Jiang ,Baoyuan Li ,Guoqing Wu ,Haitao Zheng ,Jinyao Ning ,Jinlong Ma ,Xincheng Liu ,Shaolong Hao ,Riming Liu

doi:10.3760/cma.j.issn.1674-6090.2018.01.010

Abstract

Objective To explore the clinical significance of monitoring drainage fluid parathyroid hor-mone (dPTH) for estimating the in situ reserves and function of the parathyroid by analyzing the change of serum calcium, serum parathyroid hormone (sPTH) and dPTH after thyroid surgery. Methods According to the opera-tive method, the total of 144 patients with thyroid disease were divided into five groups: unilateral lobectomy, unilat-eral lobectomy plus isthmectomy with unilateral lymph node dissection, total thyroidectomy, total thyroidectomy with unilateral lymph node dissection, and total thyroidectomy with bilateral lymph node dissection group. The blood calcium, sPTH and dPTH level of patients were tested before operation and on the 1st, 2nd, 3rd and 4th day after operation. The depression of serum calcium, hypocalcemia and hypoparathyroidism were observed after opera-tion. The serum calcium, serum PTH and dPTH level were summarized and analyzed statistically in order to evalu-ate the in situ reserves and postoperative function of the parathyroid. Results Among the 114 cases, the decline of serum calcium level mostly happened on the 2nd day after operation (70 cases, 61.4%) . There were 36 patients with hypocalcemia (31.58%) and 34 patients with hypoparathyroidism (29.82%) . Serum calcium level increased gradual-ly in all of the patients. Although sPTH level swung, it had a rising trend on the whole. The level of serum calcium and sPTH was positively correlated. The level of dPTH was discrete and decreased along with time. The decline lev-el of dPTH among different groups had statistical difference. Conclusions It is a promising method to evaluate the in situ reserves and function of the parathyroid by monitoring the level and changes of dPTH after thyroid surgery,and it is of value for preventive calcium supplementation after thyroid surgery. Key words: Thyroid surgery; Parathyroid; Hypoparathyroidism; Parathyroid hormone; Drainage fluid

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