Postoperative serum changes in calcium, phosphorus, iPTH, CRP, IL-6, and TNF-p levels in patients with secondary hyperparathyroidism

继发性甲状旁腺功能亢进患者术后血清钙、磷、iPTH、CRP、IL-6 和 TNF-p 水平的变化

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Abstract

BACKGROUND: This study investigates the impact of food structure intervention based on the fast-track surgery (FTS) concept on the postoperative nutritional status, immune response, and recovery outcomes of patients with secondary hyperparathyroidism (SHPT). Specifically, it explores changes in serum calcium and phosphorus levels, immune-reactive parathyroid hormone (iPTH), inflammatory markers (CRf) IL-6, TNF-P), and rehabilitation outcomes following surgical intervention. METHODS: Fifty SHPT patients who underwent surgery at the Third Hospital of Hebei Medical University were randomly divided into two groups: a control group (CG) receiving conventional nursing care and an observation group (OG) receiving food structure intervention based on the FTS concept. Preand postoperative comparisons were made for nutritional indicators (hemoglobin, albumin), biochemical markers (calcium, phosphorus, calcium-phosphorus product, iPTH), inflammatory markers (CRF) IL-6, TNF-P), pain levels (Visual Analog Scale), muscle strength (MRC scale), and postoperative complications. RESULTS: The OG showed significantly improved nutritional status, with higher hemoglobin and albumin levels compared to the CG. Additionally, blood calcium levels and calcium-phosphorus product were significantly elevated, while blood phosphorus and iPTH levels were reduced in the OG. Inflammatory markers (CRf) IL-6, TNF-P) were significantly lower in the OG. Pain scores (VAS) were lower, muscle strength (MRC) was higher, and the incidence of complications was significantly reduced in the OG compared to the CG. CONCLUSIONS: Food structure intervention based on the FTS concept enhances nutritional status, improves mineral metabolism, reduces postoperative inflammation, and accelerates recovery in SHPT patients. This study supports the implementation of FTS principles in perioperative care to improve outcomes and reduce complications for SHPT patients, offering valuable insights for optimising clinical management and nursing practices in this patient population.

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