SURGICAL PREVENTION AND TREATMENT OF POSTOPERATIVE HYPOPARATHYROIDISM IN PATIENTS OPERATED ON THYROID GLAND. 2018

V Skrypko, and A Pasko, and I Churpiy, and A Kovalenko, and V Zaplutanov
Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine; Institute of toxicology of Federal Medical-Biology Agency, S.-Petersburg, Russia; Department of Experimental Pharmacology, Sechenov Institute of Evolutionary Physiology and Biochemistry Russian Academy of Sciences, S.-Petersburg, Russia.

The objective of the research was to develop and evaluate the algorithm of prevention and treatment of postoperative hypoparathyroidism (PHPT) based on determining parathyroid glands (PTG) viability and the use of antihypoxant-antioxidant therapy in the postoperative period. The research was based on the results of a comprehensive examination and treatment of 60 patients who were operated for thyroid gland diseases. The patients underwent inpatient treatment at the surgical department of Ivano-Frankivsk Central City Clinical Hospital and Ivano-Frankivsk Regional Oncology Center from 2015 to 2017. We proposed an algorithm for surgical prevention and treatment of PHPT during thyroid gland surgeries which consisted in the following. We performed a visual assessment of PTG intraoperatively and evaluated each gland from 0 to 3 points according to the degree of its viability affection. If the gland was evaluated at 0-2 points, we left it in situ, since there was a high probability of maintaining its function. If it was evaluated at 3 points, its autotransplantation was performed. Cytoflavin drug was applied in a dose of 10 ml per 200 0.9% NaCl intravenously once a day during 7 days in the postoperative period for the purpose of antihypoxant-antioxidant therapy. 2 groups of patients were formed in order to evaluate the effectiveness of the algorithm. Each group consisted of 30 people. Patients of Group I underwent surgery on thyroid gland according to generally accepted rules. Patients of Group II underwent interventions according to the above-mentioned algorithm. The use of our proposed algorithm (intraoperative assessment of PTG viability and antihypoxant-antioxidant therapy in the postoperative period) significantly reduces the frequency of permanent PHPT justifying indications to its application.

UI MeSH Term Description Entries
D007011 Hypoparathyroidism A condition caused by a deficiency of PARATHYROID HORMONE (or PTH). It is characterized by HYPOCALCEMIA and hyperphosphatemia. Hypocalcemia leads to TETANY. The acquired form is due to removal or injuries to the PARATHYROID GLANDS. The congenital form is due to mutations of genes, such as TBX1; (see DIGEORGE SYNDROME); CASR encoding CALCIUM-SENSING RECEPTOR; or PTH encoding parathyroid hormone. Idiopathic Hypoparathyroidism,Hypoparathyroidism, Idiopathic
D007290 Inosine Diphosphate An inosine nucleotide containing a pyrophosphate group esterified to C5 of the sugar moiety. IDP,Inosine Pyrophosphate,Riboxin,Riboxine,Diphosphate, Inosine,Pyrophosphate, Inosine
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009536 Niacinamide An important compound functioning as a component of the coenzyme NAD. Its primary significance is in the prevention and/or cure of blacktongue and PELLAGRA. Most animals cannot manufacture this compound in amounts sufficient to prevent nutritional deficiency and it therefore must be supplemented through dietary intake. Nicotinamide,Vitamin B 3,Vitamin PP,3-Pyridinecarboxamide,Enduramide,Nicobion,Nicotinsäureamid Jenapharm,Papulex,Vitamin B3,3 Pyridinecarboxamide,B 3, Vitamin,B3, Vitamin,Jenapharm, Nicotinsäureamid
D010280 Parathyroid Glands Two pairs of small oval-shaped glands located in the front and the base of the NECK and adjacent to the two lobes of THYROID GLAND. They secrete PARATHYROID HORMONE that regulates the balance of CALCIUM; PHOSPHORUS; and MAGNESIUM in the body. Gland, Parathyroid,Glands, Parathyroid,Parathyroid Gland
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D005486 Flavin Mononucleotide A coenzyme for a number of oxidative enzymes including NADH DEHYDROGENASE. It is the principal form in which RIBOFLAVIN is found in cells and tissues. FMN,Flavin Mononucleotide Disodium Salt,Flavin Mononucleotide Monosodium Salt,Flavin Mononucleotide Monosodium Salt, Dihydrate,Flavin Mononucleotide Sodium Salt,Riboflavin 5'-Monophosphate,Riboflavin 5'-Phosphate,Riboflavin Mononucleotide,Sodium Riboflavin Phosphate,5'-Monophosphate, Riboflavin,5'-Phosphate, Riboflavin,Mononucleotide, Flavin,Mononucleotide, Riboflavin,Phosphate, Sodium Riboflavin,Riboflavin 5' Monophosphate,Riboflavin 5' Phosphate,Riboflavin Phosphate, Sodium
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000860 Hypoxia Sub-optimal OXYGEN levels in the ambient air of living organisms. Anoxia,Oxygen Deficiency,Anoxemia,Deficiency, Oxygen,Hypoxemia,Deficiencies, Oxygen,Oxygen Deficiencies

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