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[术后甲状旁腺功能减退:并发症风险]

[Postoperative hypoparathyroidism: risk of complications].

作者信息

Sawicki A

机构信息

Kliniki Endokrynologii CMKP.

出版信息

Pol Tyg Lek. 1991;46(43-44):815-7.

PMID:1669168
Abstract

For assessing the risk of adverse complications of surgery the group of 130 patients with post-operational hypoparathyroidism was analysed. Surgical hypoparathyroidism has been diagnosed in 51% of operated on thyroid gland patients. Laryngeal nerves have been damaged in 46.6% of patients. The injury to laryngeal nerves has been irreversible in 2/3 of patients, and reversible in the remaining 1/3. Cataract, nephrolithiasis and vitamin D3 intoxication have been observed in some cases before surgery. Their incidence increased in severe surgical hypoparathyroidism. Osteoporosis of the spine has been diagnosed in 49% of patients including some with vertebral fractures. No correlation between the degree of spine osteoporosis and diagnosis before surgery, number of operations on thyroid gland, and type of therapy has been noted. The symptoms of hypercalcemia have been diagnosed in 5 patients out of which hypercalcemia has been transient in 2 patients, and lasted for 1-5 months in the remaining 3 patients. The results of 7,873 analyses of mineral metabolism have been assessed. Hypocalcemia has been found in 38.4%, hypercalcemia in 1.6%, hypomagnesemia in 25.7%, hyperphosphatemia in 41.5%, decreased alkaline phosphatase serum activity in 28.7%, and hypercalciuria in 22.4% of cases. Surgical hypoparathyroidism is frequently accompanied by surgical hypothyroidism and injury to the recurrent laryngeal nerves.

摘要

为评估手术不良并发症的风险,对130例术后甲状旁腺功能减退患者进行了分析。51%的甲状腺手术患者被诊断为手术性甲状旁腺功能减退。46.6%的患者喉返神经受损。三分之二患者的喉返神经损伤为不可逆,其余三分之一为可逆。术前部分病例观察到白内障、肾结石和维生素D3中毒。在严重手术性甲状旁腺功能减退中其发生率增加。49%的患者被诊断为脊柱骨质疏松,其中部分患者有椎体骨折。未发现脊柱骨质疏松程度与术前诊断、甲状腺手术次数及治疗类型之间存在相关性。5例患者被诊断为高钙血症症状,其中2例为短暂性高钙血症,其余3例持续1至5个月。评估了7873次矿物质代谢分析结果。38.4%的病例发现低钙血症,1.6%发现高钙血症,25.7%发现低镁血症,41.5%发现高磷血症,28.7%的病例血清碱性磷酸酶活性降低,22.4%发现高钙尿症。手术性甲状旁腺功能减退常伴有手术性甲状腺功能减退和喉返神经损伤。

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