PDF(Pubmed)
Abstract：
UNASSIGNED: Parathyroidectomy under nerve monitoring has been carried out for nearly ten years in the China-Japan Union Hospital of Jilin University. We retrospectively evaluated patients\' prognosis with secondary hyperparathyroidism (SH) under neuro- and non-neuro-monitored parathyroidectomy anesthesia. The purpose of this study is to summarize and introduce a new anesthesia scheme for parathyroidectomy under nerve monitoring.
UNASSIGNED: From January 2000 to December 2019, 200 patients with SH in the China-Japan Union Hospital of Jilin University were retrospectively analyzed. Among them, 100 patients underwent parathyroidectomy under neurological monitoring (Group A), and 100 patients underwent parathyroidectomy without neurological monitoring (Group B). The dosage of muscle relaxant, parathyroid hormone (PTH), serum calcium, phosphorus, urea, creatinine, and alkaline phosphatase (ALP) was recorded before surgery (T0), after surgery (T1), at discharge (T2), during skin incision (Ta), at four parathyroidectomies (Tb), and 10 min after total removal. The levels of PTH were measured at four-time points (Tc) and 30 minutes (Td) after complete resection.
UNASSIGNED: After screening and propensity score match (PSM), the data of 92 patients were analyzed. Group A\'s muscle relaxant dose was significantly less than Group B; the length of hospital stay in Group A was significantly lower than in Group B (P<0.05). The serum calcium levels, phosphorus, urea, and creatinine at T2 in Group A were lower than those in Group B (P<0.05).
UNASSIGNED: Parathyroid nerve monitoring technology combined with preoperative complete anesthesia scheme, anesthesia induction with one time ED95 (95% effective drug dose) cis-atracurium, end breath gas, and sevoflurane maintenance anesthesia under BIS monitoring can improve the prognosis of patients, shorten the length of hospital stay, and is effective and safe.
UNASSIGNED: From January 2000 to December 2019, 200 patients with SH in the China-Japan Union Hospital of Jilin University were retrospectively analyzed. Among them, 100 patients underwent parathyroidectomy under neurological monitoring (Group A), and 100 patients underwent parathyroidectomy without neurological monitoring (Group B). The dosage of muscle relaxant, parathyroid hormone (PTH), serum calcium, phosphorus, urea, creatinine, and alkaline phosphatase (ALP) was recorded before surgery (T0), after surgery (T1), at discharge (T2), during skin incision (Ta), at four parathyroidectomies (Tb), and 10 min after total removal. The levels of PTH were measured at four-time points (Tc) and 30 minutes (Td) after complete resection.
UNASSIGNED: After screening and propensity score match (PSM), the data of 92 patients were analyzed. Group A\'s muscle relaxant dose was significantly less than Group B; the length of hospital stay in Group A was significantly lower than in Group B (P<0.05). The serum calcium levels, phosphorus, urea, and creatinine at T2 in Group A were lower than those in Group B (P<0.05).
UNASSIGNED: Parathyroid nerve monitoring technology combined with preoperative complete anesthesia scheme, anesthesia induction with one time ED95 (95% effective drug dose) cis-atracurium, end breath gas, and sevoflurane maintenance anesthesia under BIS monitoring can improve the prognosis of patients, shorten the length of hospital stay, and is effective and safe.
摘要：
■神经监测下的甲状旁腺切除术已在吉林大学中日协和医院开展了近十年。我们回顾性评估了在神经和非神经监测的甲状旁腺切除术麻醉下继发性甲状旁腺功能亢进（SH）患者的预后。目的总结并介绍一种神经监护下甲状旁腺切除术的麻醉新方案。
■回顾性分析2000年1月至2019年12月吉林大学中日协和医院200例SH患者的临床资料。其中,100例患者在神经监护下接受了甲状旁腺切除术（A组），100例患者接受了甲状旁腺切除术，没有进行神经系统监测（B组）。肌肉松弛剂的剂量，甲状旁腺激素（PTH），血清钙，磷，尿素,肌酐,术前（T0）记录碱性磷酸酶（ALP），手术后（T1），在放电（T2），在皮肤切口（Ta），在四次甲状旁腺切除术（Tb），和10分钟后完全去除。在完全切除后四个时间点(Tc)和30分钟(Td)测量PTH水平。
■筛选和倾向评分匹配（PSM）后，对92例患者的资料进行分析。A组肌松剂量明显少于B组,A组住院时间明显少于B组(P<0.05)。血清钙水平,磷，尿素,A组T2时肌酐低于B组(P<0.05)。
■甲状旁腺神经监测技术结合术前完整麻醉方案，用一次ED95（95％有效药物剂量）顺式阿曲库铵进行麻醉诱导，结束呼吸气体，七氟醚维持麻醉在BIS监测下可改善患者预后,缩短住院时间，并且是有效和安全的。
■回顾性分析2000年1月至2019年12月吉林大学中日协和医院200例SH患者的临床资料。其中,100例患者在神经监护下接受了甲状旁腺切除术（A组），100例患者接受了甲状旁腺切除术，没有进行神经系统监测（B组）。肌肉松弛剂的剂量，甲状旁腺激素（PTH），血清钙，磷，尿素,肌酐,术前（T0）记录碱性磷酸酶（ALP），手术后（T1），在放电（T2），在皮肤切口（Ta），在四次甲状旁腺切除术（Tb），和10分钟后完全去除。在完全切除后四个时间点(Tc)和30分钟(Td)测量PTH水平。
■筛选和倾向评分匹配（PSM）后，对92例患者的资料进行分析。A组肌松剂量明显少于B组,A组住院时间明显少于B组(P<0.05)。血清钙水平,磷，尿素,A组T2时肌酐低于B组(P<0.05)。
■甲状旁腺神经监测技术结合术前完整麻醉方案，用一次ED95（95％有效药物剂量）顺式阿曲库铵进行麻醉诱导，结束呼吸气体，七氟醚维持麻醉在BIS监测下可改善患者预后,缩短住院时间，并且是有效和安全的。
