Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Canada.
Otolaryngol Head Neck Surg. 2011 Oct;145(4):561-4. doi: 10.1177/0194599811414511. Epub 2011 Jul 12.
Transient post-thyroidectomy hypocalcemia is a common complication following thyroid surgery. Studies have identified risk factors and possible ways to help predict post-thyroidectomy hypocalcemia with the intent of ultimately limiting its incidence. This study evaluates the role of patient gender as a potential risk factor.
A retrospective case series with chart review of 270 consecutive total thyroidectomy patients was conducted.
Jewish General Hospital, a McGill University-affiliated hospital in Montreal, Canada.
219 women and 51 men were included. Postoperative hypocalcemia was defined as any 1 of the following: total serum calcium 1.90 mmol/L or less, or signs and symptoms of hypocalcemia. The following were evaluated as potential confounding factors in the study: age, menopause, preoperative calcium, parathyroid hormone, magnesium and phosphate levels, presence of carcinoma in the surgical specimen, number of parathyroid glands preserved in situ, thyroid gland volume, and nodule size.
Female patients experienced transient postoperative hypocalcemia in 24.7% (54/219) of cases, which was significantly greater than the 11.8% (6/51) incidence detected in men (P < .05). This represents a female/male relative risk ratio of 2.1 (confidence interval, 1.0-4.6). There was no significant difference in rates of hypocalcemia between premenopausal and postmenopausal women (22.7% vs 26.6%).
These findings suggest that being female is likely a risk factor for transient post-thyroidectomy hypocalcemia. Although this association is statistically significant, its magnitude and clinical relevance are uncertain and may be trivial. Additional research is needed to ascertain the physiologic mechanisms underlying this gender difference.
甲状腺手术后短暂性甲状旁腺功能减退症是常见的并发症。研究已经确定了风险因素和可能的预测方法，以帮助预测甲状腺切除术后甲状旁腺功能减退症，最终限制其发病率。本研究评估了患者性别作为潜在风险因素的作用。
对 270 例连续行甲状腺全切除术的患者进行回顾性病例系列和图表回顾研究。
加拿大蒙特利尔麦吉尔大学附属犹太总医院。
纳入 219 名女性和 51 名男性。术后低钙血症定义为以下任何 1 种情况：总血清钙<1.90mmol/L 或出现低钙血症的症状和体征。评估了以下可能影响研究的混杂因素：年龄、绝经、术前钙、甲状旁腺激素、镁和磷酸盐水平、手术标本中是否存在癌、原位保留的甲状旁腺数量、甲状腺体积和结节大小。
女性患者中 24.7%（54/219）发生短暂性术后低钙血症，显著高于男性的 11.8%（6/51）（P<0.05）。这表示女性/男性的相对风险比为 2.1（置信区间，1.0-4.6）。绝经前和绝经后女性的低钙血症发生率无显著差异（22.7%比 26.6%）。
这些发现表明，女性可能是甲状腺切除术后短暂性甲状旁腺功能减退症的危险因素。尽管这种关联具有统计学意义，但它的程度和临床意义尚不确定，可能微不足道。需要进一步研究确定这种性别差异的生理机制。
