摘要
目的:探究甲状腺癌患者术后造成甲状旁腺功能减退的危险因素,并分析患者生存预后情况。方法:随机选取2015年2月-2017年4月在广州医科大学附属第四医院诊断及治疗的158例甲状腺癌患者作为研究对象,所有患者均行手术治疗,根据患者术后是否发生甲状旁腺功能减退分为研究组53例(合并甲状旁腺功能减退)与对照组105例(未合并甲状旁腺功能减退)。收集患者临床病例资料,分析术后患者甲状旁腺功能减退的危险因素。对患者进行为期5年的随访,对比两组术后1、3、5年生存率情况。结果:与对照组对比,研究组患者全切、自体甲状旁腺移植、淋巴结转移、双侧中央区淋巴结清扫、术后未进行131I治疗占比均明显多,术后甲状腺激素水平明显低(P<0.05)。经多因素logistic回归模型分析发现,手术方式、淋巴结转移、术后131I治疗、术后甲状腺激素等均为甲状腺癌患者术后甲状旁腺功能减退的危险因素,未进行双侧中央区淋巴结清扫为甲状腺癌患者术后甲状旁腺功能减退的独立保护因素(P<0.05)。术后3、5年时,与对照组对比,研究组生存率均明显低(P<0.05)。结论:手术方式、淋巴结转移、术后131I治疗、术后甲状腺激素等均为甲状腺癌患者术后甲状旁腺功能减退的危险因素,未进行双侧中央区淋巴结清扫为甲状腺癌患者术后甲状旁腺功能减退的保护因素,且甲状腺癌患者术后甲状旁腺功能减退能够明显影响患者生存预后。
Objective: To investigate the risk factors causing postoperative hypoparathyroidism in patients with thyroid cancer and analyze the survival and prognosis of patients. Method: One hundred and fiftyeight patients with thyroid cancer diagnosed and treated in the Fourth Affiliated Hospital of Guangzhou Medical University from February 2015 to April 2017 were randomly selected as study subjects, and all patients were treated surgically, and the patients were divided into 53 cases in the study group(combined with hypoparathyroidism) and 105 cases in the control group(without combined hypoparathyroidism) according to whether hypoparathyroidism occurred after surgery. Cliniccal case data were collected and risk factors for postoperative hypoparathyroidism were analyzed. The patients were followed up for 5 years, and the 1, 3 and 5-year survival rate after surgery were compared between the two groups. Result: Compared to the control group, patients in the study group had a significantly higher proportion of total excision, autologous parathyroid transplantation, lymph node metastasis,bilateral lymph node dissection in the central region, no postoperative131I treatment, and significantly lower postoperative thyroid hormone levels(P<0.05). Multivariate logistic regression model analysis showed that surgical method, lymph node metastasis, postoperative131I treatment and postoperative thyroid hormone were all risk factors for postoperative hypoparathyroidism in patients with thyroid cancer, no bilateral central lymph node dissection was an independent protective factor for postoperative hypoparathyroidism in patients with thyroid cancer(P<0.05).At 3 and 5 years postoperatively, the survival rate of patients in the study group were significantly lower compared with the control group(P<0.05). Conclusion: The mode of surgery, lymph node metastasis, postoperative131I treatment, and postoperative thyroid hormone are all risk factors for postoperative hypoparathyroidism in patients with thyroid cancer, failure to perform bilateral central lymph node dissection is a protective factor for postoperative hypoparathyroidism in patients with thyroid cancer, and postoperative hypoparathyroidism in patients with thyroid cancer can significantly affect patients’ survival prognosis.
作者
吴耿刚
廖静雯
黄林萍
刘连弟
王理想
何文广
WU Genggang;LIAO Jingwen;HUANG Linping;LIU Liandi;WANG Lixiang;HE Wenguang(The Fourth Affiliated Hospital of Guangzhou Medical University,Guangzhou 511300,China;不详)
出处
《中国医学创新》
CAS
2023年第2期132-136,共5页
Medical Innovation of China
