Tejera-Hernández AA, Rodríguez-Rodríguez F, Gutiérrez-Giner MI, López-Plasencia Y, Alcalá-Serrano FJ, Hernández-Hernández JR

Idioma: Español
Referencias bibliográficas: 27
Paginas: 475-480
Archivo PDF: 169.83 Kb.

RESUMEN

Objetivo: Análisis de los valores de hormona paratiroidea (PTH) intranodular obtenidos por punción con aguja fina como factor predictivo de hipoparatiroidismo posoperatorio. Método: De los 157 pacientes a los que se realizó la medición de la PTH intranodular, se estudiaron 37 que fueron intervenidos quirúrgicamente, estableciendo 15 variables para analizar: edad, sexo, tiempo de evolución, tamaño, cirugía de tiroides asociada, tratamiento preoperatorio con calcimiméticos, litiasis renal, densitometría ósea, aclaramiento de creatinina, calcio y PTH preoperatorios, PTH determinada tras punción con aguja fina, descenso de la PTH intraoperatoria, calcio posoperatorio y malignidad de la tumoración. Estas se compararon con la prueba de ji al cuadrado o el test exacto de Fisher, siendo significativa una p ‹ 0.05, construyéndose así un análisis de regresión logística. Resultados: El uso de calcimiméticos previo a la cirugía, la PTH preoperatoria > 88 pg/dl, el calcio preoperatorio › 12 mg/dl, los valores de PTH intranodular › 2700 pg/dl, el descenso de la PTH intraoperatoria a ‹ 15 pg/dl y el calcio posoperatorio ‹ 8,5 mg/dl fueron variables independientes significativas en el análisis univariante (p ‹ 0.05) para la predicción del hipoparatiroidismo posoperatorio. Conclusiones: Los valores de PTH intranodular pueden predecir qué pacientes tienen mayor riesgo de sufrir un hipoparatiroidismo posoperatorio. Este factor debe tenerse en cuenta durante el estudio y el seguimiento de los pacientes para identificar precozmente posibles complicaciones.

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