Total Tiroidektomi Sonrası Gelişebilecek Hipokalseminin Erken Tanısında Paratiroidhormon Ölçümü

Abstract

Objective: Hypoparathyroidism is a major complication of thyroid surgery. Inadvertent removal of the parathyroid glands or nutritional deterioration of the parathyroid glands are the most important mechanisms that explains the reduction of postoperative parathyroid functions. In this study, postoperative parathyroid hormone (PTH) level was analyzed in order to prevent hypocalcaemia and enable the patients to be discharged safely. Methods: Preoperative calcium level, postoperative 20 minutes, 4 hours, 24 hours levels, 10 days and 6 months calcium level and 20 minutes, 4 hours and 24 hours PTH level and postoperative complications and histopathology results of the 85 patients who had total thyroidectomy were recorded. Patients were given calcium carbonate and/or calcitriol or they were discharged without any treatment depending on their PTH level on the postoperative 24 hours. Results: In our study, PTH levels analyzed on the postoperative 20 minutes, 4 hours and 24 hours were found to be statistically significant (p:0,0001) to be able to detect hypocalcaemia in an early stage. However PTH level was found to be statistically more sensitive (%91.5) on the postoperative 20 minutes. In our study, postoperative calcium levels were not found to be significant in detecting hypocalcaemia in an early stage that may develop after total thyroidectomy. Conclusion: We are in the opinion that with a PTH level analyzed on the 20th postoperative minute, patients can be discharged safely 24 hours after the surgery; furthermore, we also believe that in the presence of a higher level than 10 pg/ml PTH level we will not observe postoperative hypocalcaemia symptoms.