Wang Ying-Hao, Bhandari Adheesh, Yang Fan, Zhang Wei, Xue Li-Jun, Liu Hai-Guang, Zhang Xiao-Hua, Chen Cheng-Ze
Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
Cancer Manag Res. 2017 Nov 15;9:627-635. doi: 10.2147/CMAR.S148090. eCollection 2017.
Hypocalcemia is one of the most common postoperative complications following thyroid surgery in clinical practice. The occurrence of hypocalcemia is mainly attributed to hypoparathyroidism when parathyroid glands are devascularized, injured, or dissected during the surgery. The aim of this study was to analyze the risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy.
A total of 278 patients who underwent thyroid surgery were analyzed retrospectively. Univariate analysis and multivariable logistic regression were performed to discover the risk factors for hypocalcemia and hypoparathyroidism.
Postoperative hypocalcemia occurred in 76 (27.3%) patients and hypoparathyroidism occurred in 42 (15.1%) patients. Seven factors were significantly related to the presence of postoperative hypocalcemia, namely, age (=0.049), gender (=0.015), lateral lymph node dissection (=0.017), operation type (<0.001), preoperative parathyroid hormone (PTH) level (=0.035), operation time (=0.001), and applying carbon nanoparticles (CNs; =0.007). Our result revealed that gender (=0.014), lateral lymph node dissection (=0.038), operation type (<0.001), operative time (<0.001), and applying CNs (=0.001) had a significant correlation with postoperative hypoparathyroidism.
These findings were crucial for guiding surgeons to prevent the occurrence of hypocalcemia and hypoparathyroidism.
低钙血症是临床实践中甲状腺手术后最常见的术后并发症之一。低钙血症的发生主要归因于手术过程中甲状旁腺血管受损、受伤或被切除导致的甲状旁腺功能减退。本研究的目的是分析甲状腺切除术后低钙血症和甲状旁腺功能减退的危险因素。
回顾性分析了278例行甲状腺手术的患者。采用单因素分析和多变量逻辑回归分析来发现低钙血症和甲状旁腺功能减退的危险因素。
76例（27.3%）患者发生术后低钙血症，42例（15.1%）患者发生甲状旁腺功能减退。七个因素与术后低钙血症的发生显著相关，即年龄（=0.049）、性别（=0.015）、侧方淋巴结清扫（=0.017）、手术类型（<0.001）、术前甲状旁腺激素（PTH）水平（=0.035）、手术时间（=0.001）和应用碳纳米颗粒（CNs；=0.007）。我们的结果显示，性别（=0.014）、侧方淋巴结清扫（=0.038）、手术类型（<0.001）、手术时间（<0.001）和应用CNs（=0.001）与术后甲状旁腺功能减退显著相关。
这些发现对于指导外科医生预防低钙血症和甲状旁腺功能减退的发生至关重要。
