Chen Kuan-Chen, Iqbal Usman, Nguyen Phung-Anh, Hsu Chung-Huei, Huang Chen-Ling, Hsu Yi-Hsin Elsa, Atique Suleman, Islam Md Mohaimenul, Li Yu-Chuan Jack, Jian Wen-Shan
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan Department of Dermatology, Wan Fang Hospital, Taipei, Taiwan Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan School of Health Care Administration, Taipei Medical University, Taipei, Taiwan Faculty of Health Sciences, Macau University of Science and Technology, Macau, China Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Medicine (Baltimore). 2017 Oct;96(43):e8245. doi: 10.1097/MD.0000000000008245.
The main objective of this study is to investigate the outcome between surgical procedures and the risk of development of hypoparathyroidism followed by surgical procedure in patients with thyroid disorders.We analyzed the data acquired from Taiwan's Bureau of National Health Insurance (BNHI) research database from 1998 to 2011 and found 9316 patients with thyroid surgery. Cox regression model was used to calculate the hazard ratio (HR).A count of 314 cases (3.4%) of hypoparathyroidism was identified. The 9 years cumulated incidence of hypoparathyroidism was the highest in patient undergone bilateral total thyroidectomy (13.5%) and the lowest in the patient with unilateral subtotal thyroidectomy (1.2%). However, in the patients who had undergone unilateral subtotal, the risk was the highest in bilateral total (HR: 11.86), followed by radical thyroidectomy with unilateral neck lymph node dissection (HR: 8.56), unilateral total (HR, 4.39), and one side total and another side subtotal (HR: 2.80).The extent of thyroid resection determined the risk of development of hypoparathyroidism. It is suggested that the association of these factors is investigated in future studies.
本研究的主要目的是调查甲状腺疾病患者手术治疗后的结局以及手术后发生甲状旁腺功能减退的风险。我们分析了从1998年至2011年台湾国民健康保险局（BNHI）研究数据库中获取的数据，共发现9316例接受甲状腺手术的患者。采用Cox回归模型计算风险比（HR）。共识别出314例（3.4%）甲状旁腺功能减退病例。甲状旁腺功能减退的9年累积发病率在接受双侧全甲状腺切除术的患者中最高（13.5%），在接受单侧次全甲状腺切除术的患者中最低（1.2%）。然而，在接受单侧次全甲状腺切除术的患者中，双侧全甲状腺切除术患者发生甲状旁腺功能减退的风险最高（HR：11.86），其次是单侧颈部淋巴结清扫的根治性甲状腺切除术（HR：8.56）、单侧全甲状腺切除术（HR：4.39）以及一侧全甲状腺切除术加另一侧次全甲状腺切除术（HR：2.80）。甲状腺切除范围决定了甲状旁腺功能减退的发生风险。建议在未来研究中对这些因素之间的关联进行调查。
