Ozogul Bunyami, Akcay Mufide Nuran, Akcay Gungor, Bulut Ozgur Hakan
Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
Department of Internal Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
Eurasian J Med. 2014 Feb;46(1):15-21. doi: 10.5152/eajm.2014.03.
After thyroidectomy hypocalcaemia is the most significant complication for clinicians. In this study, we investigated the factors associated with development of hypocalcaemia after thyroidectomy.
We investigated the patients prospectively for age, gender, preoperative diagnosis, hormonal status, operative time, operating surgeon, existence of parathyroid gland injury at the operation, parathyroid gland auto-transplantation, preoperative use of anti-thyroid drugs and amount of bleeding at the operation. After operation in 1 and 2 days, serum calcium and phosphor, and in the 1 day parathyroid hormone values were evaluated. The chi-square test was applied in the analysis of categorical variables. Logistic regression model was used to determine the risk of hypocalcaemia in the univariate analysis.
Hypocalcaemia developed in 47 of 196 patients. Female gender, preoperative diagnosis of thyroid cancer and toxic nodular goitre, <3cm nodule size, parathyroid injury and auto-transplantation and low vitamin D levels were factors found to be associated with hypocalcaemia in the Logistic regression analysis.
The factors associated with hypocalcaemia were defined to be "gender, preoperative diagnosis, parathyroid gland injury, nodule size and vitamin D deficiency", it is a multifactorial problem and it would not be proper to define a few etiological factors.
甲状腺切除术后低钙血症是临床医生面临的最严重并发症。在本研究中,我们调查了甲状腺切除术后发生低钙血症的相关因素。
我们对患者的年龄、性别、术前诊断、激素状态、手术时间、手术医生、术中甲状旁腺损伤情况、甲状旁腺自体移植、术前抗甲状腺药物使用情况及术中出血量进行了前瞻性调查。术后1天和2天评估血清钙和磷水平,术后1天评估甲状旁腺激素值。分类变量分析采用卡方检验。单因素分析中使用逻辑回归模型确定低钙血症的风险。
196例患者中有47例发生低钙血症。逻辑回归分析发现,女性、术前诊断为甲状腺癌和毒性结节性甲状腺肿、结节大小<3cm、甲状旁腺损伤和自体移植以及维生素D水平低是与低钙血症相关的因素。
与低钙血症相关的因素被确定为“性别、术前诊断、甲状旁腺损伤、结节大小和维生素D缺乏”,这是一个多因素问题,定义少数病因因素是不合适的。