甲状腺切除术后短暂性甲状旁腺功能减退症：对604例连续患者的前瞻性研究及多因素分析
Transient hypoparathyroidism following thyroidectomy: a prospective study and multivariate analysis of 604 consecutive patients.
作者信息
Cavicchi Ottavio, Piccin Ottavio, Caliceti Umberto, De Cataldis Angelo, Pasquali Renato, Ceroni Alberto Rinaldi
机构信息
ENT Department, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy.
出版信息
Otolaryngol Head Neck Surg. 2007 Oct;137(4):654-8. doi: 10.1016/j.otohns.2007.03.001.
OBJECTIVE
The purpose of this study was to identify the risk factors for postoperative transient hypoparathyroidism in a group of patients undergoing thyroid surgery.
STUDY DESIGN
A prospective study was conducted on 604 patients undergoing thyroid surgery.
SUBJECTS AND METHODS
Gender, final diagnosis, extent of resection, biology of pathology, intrathoracic involvement, surgery for recurrent multinodular goiter, and presence and number of parathyroid glands in a surgical specimen were analyzed as risk factors for postoperative transient hypoparathyroidism. The chi-square test and a logistic regression analysis were applied.
RESULTS
On logistic regression analysis, only the extent of surgery constituted an independent variable for transient hypoparathyroidism (P = 0.001).
CONCLUSION
The extent of surgery to central and/or lateral neck lymph nodes is responsible for a high rate of transient hypoparathyroidism owing to a high probability of unplanned parathyroidectomy or parathyroid gland devascularization.
目的
本研究旨在确定一组接受甲状腺手术患者术后发生短暂性甲状旁腺功能减退症的危险因素。
研究设计
对604例接受甲状腺手术的患者进行前瞻性研究。
研究对象与方法
分析性别、最终诊断、切除范围、病理生物学、胸腔内受累情况、复发性多结节性甲状腺肿手术以及手术标本中甲状旁腺的存在情况和数量，将其作为术后短暂性甲状旁腺功能减退症的危险因素。应用卡方检验和逻辑回归分析。
结果
逻辑回归分析显示，仅手术范围是短暂性甲状旁腺功能减退症的独立变量（P = 0.001）。
结论
由于计划外甲状旁腺切除术或甲状旁腺血运阻断的可能性较高，中央和/或侧颈淋巴结的手术范围是导致短暂性甲状旁腺功能减退症发生率较高的原因。
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