PARATHYROID HORMONE VALUES IN THYROID GLAND SURGERIES BY HARMONIC SCALPEL AND BY CONVENTIONAL METHODS
Autori:
Stjepan Grabovac, Drago Prgomet, Saša Janjanin, Ana Đanić Hadžibegović
Sažetak
Ispitali smo postoje li razlike u intraoperacijskim i ranim postoperacijskim koncentracijama paratiroidnog hormona između prve skupine bolesnika kod kojih je izvršena tiroidektomija s pomoću ultrazvučnog rezača te druge skupine bolesnika operiranih standardnom tehnikom s pomoću elektrokoagulacije i ligatura kao hemostatskih metoda. U svih bolesnika s totalnom tiroidektomijom uzeta je krv u četiri mjerne točke: neposredno nakon indukcije u anesteziju, 10 minuta nakon odstranjenja prvog režnja štitnjače, 10 minuta nakon potpunog odstranjenja štitnjače i 24 sata nakon operacije. Iz uzoraka krvi određena je koncentracija paratiroidnog hormona s pomoću imunoradiometrijskog testa. Usporedba koncentracija paratiroidnog hormona između prve i druge skupine nije pokazala statistički značajnu razliku ni za jednu od četiri mjerne točke. Usporedba koncentracija paratiroidnog hormona unutar istih skupina u odnosu na prijeoperacijske vrijednosti (prvu mjernu točku) pokazala je da su u obje skupine koncentracije paratiroidnog hormona u sve tri postincizijske mjerne točke bile značajno niže od koncentracija izmjerenih prije početka operacije (p<0,0005).
Summary
We have examined if there are any differences in intraoperative and early postoperative concentrations of parathyroid hormone between the first group of patients, who had thyroidectomy surgery performed by harmonic scalpel, and the second group of patients operated on by standard techniqes with the use of electrocoagulation and ligature as primary hemostatic procedures. All the patients having total thyroidectomy had their blood taken in four measurement points; immediately after the induction anesthesia, 10 minutes after the first thyroid gland lobe removal, 10 minutes after total thyroid gland removal and 24 hours after the surgery. The blood samples were used to determine concentrations of the parathyroid hormone by an immunoradiometric test. The concentration comparison of parathyroid hormone between the first and the second group has not shown statistically significant difference for any of the four measurement points. The concentration comparison of parathyroid hormone within the same groups in relation to preoperational values (the first measurement point) has shown that in both groups the parathyroid hormone concentration, in all three post-incision measurement points, has been significantly lower in relation to the concentration measured before the surgery (p<0.0005).
