摘要
目的:探讨甲状腺全切术后的甲状旁腺激素(PTH)及血钙的变化,评估甲状旁腺功能,总结甲状腺全切术后甲状旁腺功能减退和低钙血症的预防和处理方法。方法:73例行甲状腺全切的患者,根据手术范围将患者分为3组,收集患者术前、术后1h、1、3d及5d的PTH及血钙值,比较各组间及组内的血PTH、血钙变化。结果:各组术后PTH、血钙较术前均明显下降(P<0.05),手术前后均有低PTH和低钙血症发生。甲状腺全切除及双侧颈淋巴结清扫>甲状腺全切除及单侧颈淋巴清除术>甲状腺全切除术,差异有统计学意义(P<0.05)。甲状腺全切术后1h与术后1d的PTH能有效地预测低钙血症。结论:甲状腺全切术影响甲状旁腺功能,手术范围越大,发生甲状旁腺功能减退及低钙血症的可能性越大,选择合理的术式及术中尽可能保护甲状旁腺能减少甲状旁腺功能减退的发生,同时术后血清PTH也可作为预测低钙血症的指标。
Objective：To explore the changes of parathyroid hormone （PTH） and serum calcium after total thyroidectomy and summarize the methods to prevent and treat the hypoparathyroidism and hypocalcemia. Method： Seventy-three patients with total thyroidectomy in our hospital were divided into three groups according to the scope of the operation. The serum concentrations of PTH and calcium were measured and compared before surgery and after surgery 1 h, 1 d, 3 d and 5 d. Result：In three groups, the serum concentrations of PTH and calcium were significantly decreased （P〈0.05） after surgery and low serum PTH and hypocalcemia occured. The severity of low serum PTH and hypocalcemia was as follows： total thyroidectomy with bilateral compartment lymph node dissection （CLND）〉total thyroidectomy with unilateral CLND〉total thyroidectomy. The differences were statis- tically significant. The levels of PTH after surgery 1 hour and 1 day were effective to predict hypocalcemia. Conclusion：Total thyroidectomy can affect the parathyroid function. The greater the scope of surgery, the higher the possibility of postoperative hypoparathyroidism. The reasonable operative procedures and more protection of parathyroid during operation can reduce the incidence of hypoparathyroidism. The level of postoperative PTH can be used as a predictive index of hypocalcemia.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2015年第11期984-987,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
安徽省科技厅重点课题(No:12070403060)
