Liu Long, Yang Jianming
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jun;29(11):984-7.
To explore the changes of parathyroid hormone (PTH) and serum calcium alter total thyroidectomy and summarize the methods to prevent and treat the hypoparathyroidism and hypocalcernia.
Seventy-three patients with total thyroidectomy in our hospital were divided into three groups according to the scope of the operation. The serum concentrations of PTH and calcium were measured and compared before surgery and after surgery 1 h, 1 d, 3 d and 5 d.
In three groups, the serum concentrations of PTH and calcium were significantly decreased (P<0. 05) after surgery and low serum PTH and hypocalcemia occured. The severity of low serum PTH and hypocalcemia was as follows: total thyroidectomy with bilateral compartment lymph node dissection (CLND)>total thyroidectomy with unilateral CLND>total thyroidectomy. The differences were statistically significant. The levels of PTH after surgery 1 hour and 1 day were effective to predict hypocalcemia.
Total thyroidectomy can affect the parathyroid function. The greater the scope of surgery, the higher the possibility of postoperative hypoparathyroidism. The reasonable operative procedures and more protection of parathyroid during operation can reduce the incidence of hypoparathyroidism. The level of postoperative PTH can be used as a predictive index of hypocalcemia.
探讨甲状腺全切除术后甲状旁腺激素（PTH）及血钙的变化，总结预防和治疗甲状旁腺功能减退及低钙血症的方法。
将我院73例行甲状腺全切除术的患者根据手术范围分为三组。分别于术前及术后1小时、1天、3天和5天测定并比较血清PTH和钙的浓度。
三组患者术后血清PTH和钙浓度均显著降低（P<0.05），出现低血清PTH和低钙血症。低血清PTH和低钙血症的严重程度为：双侧颈淋巴结清扫术（CLND）的甲状腺全切除术>单侧CLND的甲状腺全切除术>甲状腺全切除术。差异有统计学意义。术后1小时和1天的PTH水平对预测低钙血症有效。
甲状腺全切除术可影响甲状旁腺功能。手术范围越大，术后甲状旁腺功能减退的可能性越高。合理的手术操作及术中对甲状旁腺的更多保护可降低甲状旁腺功能减退的发生率。术后PTH水平可作为低钙血症的预测指标。
