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常规术后补充维生素 D 和钙在甲状腺全切除术后的应用:一项荟萃分析。

Routine postoperative administration of vitamin D and calcium after total thyroidectomy: a meta-analysis.

机构信息

Department of Surgery, School of Medicine, Universidad de La Sabana, Bogota, Campus Puente del Comun, Km 21 Autopista Norte, Chia, Colombia.

出版信息

Int J Surg. 2011;9(1):46-51. doi: 10.1016/j.ijsu.2010.08.006. Epub 2010 Sep 8.

DOI:10.1016/j.ijsu.2010.08.006
PMID:20804871
Abstract

BACKGROUND

Temporary hypocalcemia is a frequent complication after total thyroidectomy. Routine postoperative administration of vitamin D and calcium can reduce the incidence of symptomatic postoperative hypocalcemia. We undertook a systematic review to assess the effectiveness of this intervention.

METHODS

We identified randomized controlled trials comparing the administration of vitamin D or metabolites to oral calcium or no treatment in patients after total thyroidectomy in MEDLINE, EMBASE and LILACS databases.

RESULTS

Four studies with 706 patients were included: 346 in the calcitriol group, 288 in the oral calcium group and 72 in the control group. The rates of hypocalcemia symptoms were 4%, 19% and 31%, respectively. The OR value for the comparison between calcitriol + calcium as compared to no treatment and to exclusive calcium treatment groups was 0.32 (95% CI, 0.13-0.79) and 0.31 (95% CI, 0.14-0.70), respectively.

CONCLUSION

The prophylactic treatment with vitamin D or metabolites + calcium is effective to decrease the incidence of symptoms of temporary hypocalcemia.

摘要

背景

全甲状腺切除术后暂时性低钙血症是一种常见的并发症。术后常规给予维生素 D 和钙可以降低有症状的术后低钙血症的发生率。我们进行了一项系统评价,以评估这种干预措施的有效性。

方法

我们在 MEDLINE、EMBASE 和 LILACS 数据库中确定了比较全甲状腺切除术后患者给予维生素 D 或代谢物与口服钙或不治疗的随机对照试验。

结果

共有 4 项研究纳入 706 例患者:骨化三醇组 346 例,口服钙组 288 例,对照组 72 例。低钙血症症状发生率分别为 4%、19%和 31%。骨化三醇+钙与不治疗和单独补钙治疗组相比,OR 值分别为 0.32(95%CI,0.13-0.79)和 0.31(95%CI,0.14-0.70)。

结论

预防性给予维生素 D 或代谢物+钙可有效降低暂时性低钙血症症状的发生率。

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