Postoperative Parathyroid Hormone And Serum Calcium Level Monitoring As A Guide To Calcium Supplementation After Total Or Post Total Thyroidectomy

In recent years, there is an upward trend in the incidence of thyroid cancer around the world,which is a common endocrine tumors.Surgical treatment is the important treatment method and hypocalcemia is one of the most common complications after thyroidectomy.Devascularization and unintended resection give rise to the hypoparathyroidism,which leads to postoperative hypocalcemia.The manifestations of hypocalcemia include circumoral paresthesias, numbness,tstany,muscle cramping and so on.When seriously it threats life.All of these bring the pain to the patient,and at the same time, make the patient's mind by great trauma affecting the quality of life(QoL).Routine monitoring parathyroid hormone and serum calcium predicts the occurrence of hypocalcemia after total or post total thyroidectomy.But there is not an unification of specific parathyroid hormone testing time and defined the value.Most people deem that it is the most significant to predict hypocalceima that parathyroid levels is detected 1h-1d postoperative thyroidectomy. V escan etc. think it makes sense of serum PTH that is obtained 1h postoperative thyroidectomy less than 1.1 pmol/L.The parathyroid glands can play a compensatory function to maintain normal blood calcium levels when the serum PTH more than 1.6 pmol/L.Scu rry etc. suggest PTH value that is measured 10 min after surgery less than 7 pg/ml or 25% of the original,has a significant meaning of predicting the asymptomatic hypocalcemia.Quiro s etc. think that RPTH value which is less than 10 pg/ml can effectively predict postoperative hypoparathyroidism.Although there is not an unified conclusion to predict the critical value of postoperative hypocalcemia and postoperative most significantly testing time by monitoring parathyroid hormone and blood calcium.The correlation of the existence still needs further research.For hypocalceima,we should improve the quality of patients' life by early detection and treatment timely.Sanabria and Alhefdhi think that preventive calcium supplement can not only reduce the risk of hypocalcemia, but also alleviate the degree of clinical symptoms after total or post total thyroidectomy.But some people opposed the idea.But when the patients exhibited clinical symptoms of hypocalcemia, we should give calcium supplementation in time,including venous filling calcium, oral calcium and vitamin D.The patients also need to regularly countercheck the blood calcium and parathyroid hormone.In the thyroid surgery to find and protect the parathyroid gland is increasingly difficult.To a certain extent,Clinicians can improve the detection rate of parathyroid gland through naked eye identification, cooperating nuclide, methylene blue staining, reactive lymph tracer, parathyroid tablet and intraoperative rapid pathological.Elaborately anatomying after the capsule,in situ protection and laryngeal recurrent nerve from the inside-out approach way can maximize the protection of the parathyroid gland.Due to the limited domestic conditions or inmature technology,the parathyroid cryopreservation technology, the transplantation of parathyroid gland, PTH replacement therapy and gene therapy are not a large-scale promotion.