Sung Tae-Yon, Lee Yu-mi, Yoon Jong Ho, Chung Ki-Wook, Hong Suck Joon
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwan-gil, Songpa-Gu, Seoul, 138-736, Korea.
Surg Today. 2016 Mar;46(3):356-62. doi: 10.1007/s00595-015-1216-1. Epub 2015 Aug 29.
Hypocalcemia after total thyroidectomy is a concern for every endocrine surgeon. We conducted this study to establish the value of the macroscopic appearance of preserved parathyroid glands after thyroidectomy in predicting post-thyroidectomy hypocalcemia.
In 2009, 237 patients underwent total thyroidectomy at our hospital. The macroscopic appearance of the preserved parathyroid glands was recorded and the serum calcium and intact parathyroid hormone levels were measured postoperatively.
Thirteen patients (5.5 %) had transient hypocalcemia and 1 patient (0.4 %) had permanent hypocalcemia. All of the hypocalcemia patients with more than one normal preserved parathyroid had asymptomatic transient hypocalcemia that did not require medication. The sensitivity, specificity, positive predictive value, and negative predictive value for hypocalcemia with at least 1 normal preserved parathyroid were 78.6, 79.4, 19.3, and 98.3 %, respectively.
The macroscopic appearance of preserved parathyroid glands and the number of well-preserved parathyroid glands after thyroidectomy proved effective in predicting post-thyroidectomy hypocalcemia.
全甲状腺切除术后低钙血症是每位内分泌外科医生所关注的问题。我们开展这项研究以确定甲状腺切除术后保留甲状旁腺的大体外观在预测术后低钙血症方面的价值。
2009年，我院237例患者接受了全甲状腺切除术。记录保留甲状旁腺的大体外观，并在术后测量血清钙和完整甲状旁腺激素水平。
13例患者（5.5%）出现短暂性低钙血症，1例患者（0.4%）出现永久性低钙血症。所有保留一个以上正常甲状旁腺的低钙血症患者均有无症状短暂性低钙血症，无需药物治疗。至少保留1个正常甲状旁腺时，低钙血症的敏感性、特异性、阳性预测值和阴性预测值分别为78.6%、79.4%、19.3%和98.3%。
甲状腺切除术后保留甲状旁腺的大体外观及保存良好的甲状旁腺数量被证明在预测术后低钙血症方面有效。
