Study on Rapid Intraoperative Parathyroid Hormone to Identify and Protect Parathyroid Gland during Total Thyroidectomy

Author(s): Ding Zhaodong, Qi Hong, Wang Ying, Ma Guiliang

Objective: By comparison and analysis preoperative and postoperative related indicators of the Control group (group A) and Fine-needle aspiration(FNA) rapid intraoperative parathyroid hormone (rIO-PTH) group (group B) .To further explore whether rIO-PTH has a certain value for the intraoperative identification and protection of the parathyroid glands, and reduce the incidence of hypoparathyroidism and hypocalcemia in postoperative. Improve the quality of life of patients with thyroidectomy. Methods: In this study, the patients were divided into group A, group B, with 35 cases in each group. In group B, the suspected parathyroid tissues was aspirated by FNA. Parathyroid gland was identified by the concentration of rIO-PTH in the puncture fluid. In group A, only in the traditional thyroid surgery way. Comparative analysis of postoperative PTH and blood calcium, numbers of intraoperative identification of parathyroid glands, the incidence of hypoparathyroidism and hypocalcemia in postoperative. Results: During the operation, the parathyroid glands were identified, the average of group A was (2.60.3), the average of group B was (3.00.2). There was a statistically significant difference in the average number of parathyroid glands between the two groups (P<0.05). Postoperative blood calcium and PTH levels were decreased in all the two groups, and the differences were statistically significant (p < 0.05) on the 1st, 4th, 7th and 30th day after surgery. The incidence of postoperative hypocalcemia was 28.6% (10/35) in group A and 8.6% (3/35) in group B. The incidence of postoperative hypothyroidism was 37.1% (13/35) in group A and 14.3% (5/35) in group B. The incidence of hypocalcemia and hypothyroidism in the two groups was statistically significant difference (P < 0.05). Conclusion: Fine-needle aspiration (FNA) rapid intraoperative detection of parathyroid hormone (rIO-PTH) can identify parathyroid tissue. rIO-PTH can significantly reduce the excessive reduction of postoperative blood calcium and PTH levels in patients, and effectively reduce the incidence of postoperative hypocalcemia and hypothyroidism. rIO-PTH has high clinical application value in identifying and protecting parathyroid gland in thyroid surgery.

Parathyroid Gland, Fine Needle Aspiration, Rapid Intraoperative Parathyroid Hormone, Hypocalcemia, Hypothyroidism

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