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[甲状腺全切除术后低钙血症的发生率]

[Incidence of hypocalcemia after total thyroidectomy].

作者信息

Gac E Patricio, Cabané T Patricio, Amat V José, Huidobro G Felipe, Rossi F Ricardo, Rodríguez F Francisco, Ferrada V Carlos, Cardemil R Francisco

机构信息

Departamento de Cirugía Endocrina y General, Hospital Clínico, Universidad de Chile, Santos Dumont, Chile.

出版信息

Rev Med Chil. 2007 Jan;135(1):26-30. doi: 10.4067/s0034-98872007000100004. Epub 2007 Mar 6.

Abstract

BACKGROUND

Postoperative hypocalcemia is one of the most common complications of thyroid surgery. It is related to the type of disease (malignant or benign), the number of identified parathyroid glands during the surgical procedure, and the surgeon's experience. Total thyroidectomy is the procedure of choice in our hospital for benign and malignant thyroid disease, but it can increase the incidence of complications.

AIM

To evaluate the incidence of postoperative hypocalcemia in patients subjected to a total thyroidectomy.

MATERIAL AND METHODS

Two studies were performed. A retrospective review of medical records of 448 patients subjected to total thyroidectomy, looking for serum calcium levels of less than 8 mg/dl and clinical signs of hypocalcemia. In a second study, 45 patients were followed with measurements of preoperative and postoperative serum calcium levels.

RESULTS

In the retrospective study, only 136 records had reliable information. Clinical signs of hypocalcemia were registered in 14% of patients and a low serum calcium level was detected in 50%. In the prospective study, 42% of patients had a postoperative low serum calcium level and seven patients (15%) had symptoms. Patients were handled with oral calcium and calcitriol in some cases. Ninety nine percent of patients had normal serum calcium levels two moths after surgery.

CONCLUSIONS

In this series, the rate of postoperative hypocalcemia after total thyroidectomy is similar to international reports.

摘要

背景

术后低钙血症是甲状腺手术最常见的并发症之一。它与疾病类型(恶性或良性)、手术过程中识别出的甲状旁腺数量以及外科医生的经验有关。在我们医院,全甲状腺切除术是治疗良性和恶性甲状腺疾病的首选术式,但它会增加并发症的发生率。

目的

评估接受全甲状腺切除术患者术后低钙血症的发生率。

材料与方法

进行了两项研究。一项对448例行全甲状腺切除术患者的病历进行回顾性分析,查找血清钙水平低于8mg/dl以及低钙血症的临床体征。另一项研究中,对45例患者术前和术后血清钙水平进行测量随访。

结果

在回顾性研究中,仅有136份记录有可靠信息。14%的患者出现低钙血症的临床体征,50%检测到血清钙水平低。在前瞻性研究中,42%的患者术后血清钙水平低,7例(15%)有症状。部分患者采用口服钙剂和骨化三醇治疗。99%的患者术后两个月血清钙水平正常。

结论

在本系列研究中,全甲状腺切除术后低钙血症的发生率与国际报告相似。

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