摘要
目的分析全甲状腺切除术后甲状旁腺功能减退症(HPT)患者甲状旁腺激素(PTH)恢复至正常水平的时间、变化规律及其影响因素。方法回顾性分析2017年1月至2020年8月因甲状腺相关疾病行全甲状腺切除术(TT)后出现HPT的49例患者的病历资料,分析患者PTH恢复至正常参考值下限时间及各时间段患者的分布情况;采用单因素分析相关临床因素与恢复时间的关系,并以性别、不同年资术者、是否行中央区淋巴结清扫、手术时间及术后第1天PTH水平5项因素作为自变量,进一步进行多元线性回归分析。结果术后PTH恢复至正常参考值下限的时间,1周之内28.6%(14/49)、1~2周32.7%(16/49)、2~4周26.5%(13/49)、1~3个月8.2%(4/49)、3~6个月4.1%(2/49)。TT术后第1天血PTH水平越接近于正常水平者,其恢复时间越短;第1天血PTH水平越低其恢复时间越长。是否行中央区淋巴结清扫、术后第1天PTH水平是影响TT后PTH恢复至正常水平的重要因素(P值均<0.05)。未发现永久性HPT患者。结论接受TT治疗后暂时性HPT患者,PTH水平恢复至正常多在术后3个月内,术后第1天PTH水平与恢复时间呈负相关。
Objective To analyze the time to return to normal levels of parathyroid hormone(PTH),the pattern of change and its influencing factors in patients with hypoparathyroidism(HPT)after total thyroidectomy.Methods The medical records of 49 patients who had HPT after total thyroidectomy(TT)for thyroid-related diseases from January 2017 to August 2020 were retrospectively analyzed.The recovery time from PTH reduction to return to the lower limit of normal reference values and the distribution of patients by period were analyzed.The relationship between relevant clinical factors and recovery time was analyzed using univariate analysis,and further multiple linear regression analysis was performed using five factors as independent variables:gender,different years of operation,whether lymph node dissection was performed in the central region,time of operation and PTH level on the first day after the operation.Results The time to recovery of PTH to the lower limit of normal reference value after surgery was 28.6%(14/49)within 1 week,32.7%(16/49)within 1-2 weeks,26.5%(13/49)within 2-4 weeks,8.2%(4/49)within 1-3 months,and 4.1%(2/49)within 3-6 months.The closer the blood PTH level was to the normal level on the first day after TT,the shorter the recovery time;the lower the blood PTH level on the first day,the longer the recovery time.Whether lymph node dissection was performed in the central region and the PTH level on postoperative day 1 were important factors affecting the recovery of PTH to normal levels after total thyroidectomy(all P<0.05).No patients with permanent HPT were identified.Conclusion In patients with temporary HPT after receiving TT treatment,PTH levels returned to normal within 3 months mostly after surgery,and PTH levels on postoperative day 1 were negatively correlated with the recovery time.
作者
张国芬
李腾雁
姜楠
杨国山
赵力
潘丽洁
ZHANG Guofen;LI Tengyan;JIANG Nan;YANG Guoshan;ZHAO Li;PAN Lijie(Department of General Surgery,the First Hospital of Tsinghua University,Beijing 100016,China)
出处
《中国研究型医院》
2021年第6期45-48,共4页
Chinese Research Hospitals
