| Objective:By giving the prophylactic calcium supplementation to the total thyroidectomy patients after their operations, to discuss the influence of prophylactic calcium supplementation to the hypoparathyroidism patients.Method:232 patients who meet selected criteria were were divided into group A (prophylactic calcium supplementation) and B(no prophylactic calcium supplementation) by the parity of operation sequence, and then based on the lowest PTH value within three days after surgery, group A were divided into group A1 (PTH>8pg/ml)and A2 (PTH< 8pg/ml), group B were divided into group B1 (PTH>8pg/ml)and B2 (PTH< 8pg/ml). All patients in group A whom were immediately supplemented Prophylactic 10% calcium gluconate intravenously 6g/d after operations. Anyone in group B who developed the syndromes of hypocalcemia or not appear hypocalcemia but detect PTH less then 8pg/ml were supplemented Prophylactic 10% calcium gluconate intravenously (Ⅳ) 6g/d at this time.20 patients in my department who had unilateral groin hernia repair surgery were assigned to group C. The serum calcium, parathyroid hormone (PTH) and of all patients in group A1 and B1 were assayed in the preoperation, first, second, third,seventh day and a month after the operations and record hypocalcemia clinical manifestation. The serum calcium, parathyroid hormone (PTH) and of all patients in group A1 and B1 were assayed in the preoperation, first, second, third,7th,14th,21th day and a month after the operations and record hypocalcemia clinical manifestation and gave a mark according to Clinical manifestations of hypocalcemia.Result:1 (1) The serum PTH and calcium levels of group A1 and B1 obviously decreased after surgery and to a minimum on the second,then increased gradually. (2) The first day after operation:The variance of PTH between two groups was no significance [A1/B1 is (17.89±6.42)/(18.13±5.49) pg/ml,P>0.05], but the serum calcium of group A1 was higher than group B1 [A1/B1 is (2.12±0.09) /(2.09±0.08)mmol/L, P<0.05].The second day after operation:The variance of PTH between two groups was no significance [A1/B1 is (11.70±4.80)/(12.58±3.12)pg/ml, P>0.05], but the serum calcium of group A1 was higher than group B1 [A1/B1 is (2.09±0.13)/(2.04±0.11)mmol/L, P<0.05].The third day after operation:The variance of PTH between two groups was no significance [A1/B1 is (16.78±6.09)/ (15.45±6.32) pg/ml, P>0.05], but the serum calcium of group A1 was higher than group B1 [A1/B1 is (2.16±0.17)/(2.13±0.05) mmol/L, P<0.05]. The 7th day after operation:The PTH calcium of group A1 was obviously higher than group B1 [A1/B1 is (28.08±8.61)/(25.41±8.27)pg/ml, P<0.05]; The serum calcium of group A1 was obviously higher than group B1 [A1/B1 is (2.27±0.10)/(.2.24±0.06)mmol/L, P< 0.05)]. The 30th day after operation:The variance of PTH between two groups was no significance,the variance of calcium between two groups was no significance too.There were 2(2.3 percent) hypocalcium patients in group A1,8(9.7 percent) in group B1,the hypocalcium incidence of group A1 was obviously lower than group B1(p<0.05).2(1) The serum PTH and calcium levels of group A2 and B2 obviously decreased after surgery and to a minimum on the second,then increased gradually.(2) The variance of PTH between two groups was no significance in the first,second and third day(P>0.05),but the variance of the serum PTH levels in the 1st week,2nd week, and 3rd week post-operation (PO) between two groups had significance (P< 0.05), and which in group A2 were higher than group B2 respectively;The serum PTH and levels of group A2 returned to normal earlier than group B2. There were 16(53.3 percent) hypocalcium patients in group A1,25(78.1 percent) in group B1,the hypocalcium incidence of group A1 was obviously lower than group B1(p<0.05).(3) The score with hypocalcemia between two groups was no significance in the 2nd week, but the score with hypocalcemia in the first, second, third and seventh day post-operation between two groups had significance (P<0.05), and which in group B2were higher than group A2 respectively (P<0.05).Conclusion:The preventively calcium supplementation can be beneficial for the parathyroid glands recovering functionally after total thyroidectomy and also can abate the syndromes of hypocalcaemia efficiently. The preventively calcium supplementation can lessen the physical and psychological influence of hypocalcaemia to these patients.
|
PDF Full Text Request