ART OF MEDICINE 2017

 

HYPOPARATHYROIDISM MECHNISMS AFTER THYROID GLAND SURGERY AND THE IMPORTANCE OF ACTIVE FORMS OF OXYGEN IN THE DEVELOPMENT OF THIS COMPLICATION

 

A.Ja. Pasko, V.D. Skrypko

          SHEI “Ivano-Frankivsk National Medical University”, Ivano-Frankivsk, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

  

Abstract

Abstract. The article deals with the prevention improvement and treatment of postoperative hypoparathereosis in patients operated on the thyroid gland. Diseases of the thyroid gland take the second place in the structure of diseases of the endocrine system after diabetes mellitus. Over the past ten years, a number of studies have shown a great increase in the incidence of various forms of goiter and cancer of the thyroid gland. The surgery on the thyroid gland refers to technically complex surgical interventions due to the anatomical placement of the thyroid gland and the vital organs of the neck. The most frequent specific complication after operations on the thyroid gland is postoperative hypoparathyroidism, which is caused by trauma of the prethyroid gland due to the mechanical, thermal influence on them during the surgery, devascularization of the prethyroid glands, or unintentional removal. So, according to the references, transient hypoparathyroidism occurs in average of 30-60% of operated patients, and is constant at 6-12%. This article reveals the results of the examination and treatment of 100 patients with different pathology of the thyroid gland (surgical department of the Ivano-Frankivsk Central City Clinical Hospital and the surgical department of the Precarpathian Clinical Cancer Center). The clinical and laboratory parameters of patients with transient and permanent postoperative hypoparathyreosis were studied and compared with those without hypoparathyroidism. Changes in the system of active forms of oxygen, lipid peroxidation and oxidative modification of proteins in operated patients have been investigated and greater damage in patients with transient and permanent hypoparathyroidism is shown in comparison with the control group. This allowed to expand the data on the relationship of oxidative stress with the course of the postoperative period and the impact on the early and long-term consequences of the transferred pathological process. It is established that in patients after thyroid surgery there is a probable increase in the intensity of OMP and LPO. Reliable growth of OMS and LPO products in patients without signs of HPT was detected in comparison with control group. However, a significantly higher OMP in patients with signs of HPT has been noted compared with patients without signs of HPT. However, vivid difference between its transient and continuous forms has not been revealed. We have established a significant decrease in the AOS enzymes in patients with thyroid carcinoma, both with and without the presence of signs of hypertension. We have noted significantly lower rates of AOS enzymes in the group of patients with the presence of signs of HPT in comparison with the group of patients without signs of HPT. However, we did not find a reliable difference between its transient and permanent form. The above data will allow us to continue research in these areas for the development of tactics for a surgical and conservative prophylactic treatment algorithm to improve the outcomes of postoperative hypoparathyroidism.

 

Key words: thyroid surgery, hypoparathyroidism, oxidative modification of proteins, lipidperoxidation, catalase, superoxidedismutase.

 

Full text: PDF (Rus)

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