Papaj Piotr, Kozieł Sławomir, Mrowiec Sławomir
Beskid Centre of Oncology - City Hospital named after John Paul II in Bielsko-Biała, General Surgery Ward. Adress: 21 Wyspianskiego street, 43-300 Bielsko-Biala, Poland] Ward supervisor: dr Józef Wróbel.
2 University of Bielsko-Biała, Faculty of Health Sciences, Dean: dr Rafał Bobiński Wydział Nauk o Zdrowiu.
Pol Przegl Chir. 2017 Apr 30;89(2):26-30. doi: 10.5604/01.3001.0009.8977.
Thyroidectomy is a common surgery performed especially in treatment of multinodular goitre. The most common post-thyroidectomy complication is a postoperative hypocalcaemia, and the percentage of postoperative hypoparathyroidism could reach even 50%. Tested group and methods: A forward-looking, randomized testing was done on a group of 113 women being subject to multinodular goitre surgery. In this article, we wish to present an analysis of the results obtained in the control group, focusing on the predicative factors which determine the development of postoperative hypocalcaemia. Obtained results: The rate of postoperative biochemical hypocalcaemia development was significantly higher in the group of patients, where the preoperative calcium concentration was lower than 2,4 mmol/l. In that group, the development of biochemical hypocalcaemia was observed in 93,7% of cases (30 out of 32 patients), in comparison with 65,3% (17 out of 26) in the group of higher preoperative concentration of calcium. The highest risk of occurrence of postoperative hypocalcaemia was borne by the total thyroidectomy, while the lowest one by the subtotal thyroid lobectomy of one lobe only.
A higher preoperative concentration of calcium in blood serum is related to the lower rate of occurrence of postoperative biochemical hypocalcaemia. However, no such correlation was revealed in the case of postoperative symptomatic hypocalcaemia. Lack of correlation was determined between the preoperative concentration of TSH and FT4 in blood serum and the rate of occurrence of postoperative hypocalcaemia, both symptomatic and asymptomatic. The performed statistics did not reveal a relation between the postoperative hypocalcaemia and the duration of the surgery, but a significant correlation was stated with the scope of the performed surgery. Revealing a relation between the rate of occurrence of postoperative hypocalcaemia and the experience of the surgeon performing the surgery was not successful.
甲状腺切除术是一种常见手术，尤其用于治疗多结节性甲状腺肿。甲状腺切除术后最常见的并发症是术后低钙血症，术后甲状旁腺功能减退的发生率甚至可达50%。测试组与方法：对113名接受多结节性甲状腺肿手术的女性进行了前瞻性随机测试。在本文中，我们希望对对照组获得的结果进行分析，重点关注决定术后低钙血症发生的预测因素。获得的结果：术前血钙浓度低于2.4 mmol/l的患者组中，术后生化性低钙血症的发生率显著更高。在该组中，93.7%的病例（32例患者中的30例）出现了生化性低钙血症，而术前血钙浓度较高的组中这一比例为65.3%（26例中的17例）。全甲状腺切除术术后发生低钙血症的风险最高，而仅切除一侧叶的甲状腺次全切除术风险最低。
血清中术前血钙浓度较高与术后生化性低钙血症的发生率较低相关。然而，术后症状性低钙血症的情况未显示出这种相关性。血清中术前促甲状腺激素（TSH）和游离甲状腺素（FT4）的浓度与术后低钙血症（包括症状性和无症状性）的发生率之间未发现相关性。所进行的统计未显示术后低钙血症与手术持续时间之间的关系，但与所实施手术的范围存在显著相关性。未成功揭示术后低钙血症的发生率与实施手术的外科医生经验之间的关系。
