Chen Z, Dong H H, Ye Z
Department of Thyroid Head and Neck Surgery,Zhengzhou Center Hospital Affiliated to Zhengzhou University,Zhengzhou,450007,China.
Department of Head and Neck Surgery,Henan Cancer Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Aug 5;30(15):1232-1235. doi: 10.13201/j.issn.1001-1781.2016.15.014.
The aim of this study is to detect the changes of parathyroid hormone and serum calcium levels before and after operation,and evaluate the effect and treatment of parathyroid function after total thyroidectomy.One hundred and seventy-two cases of initial total thyroidectomy were analysed retrospectively,who were divided into simple total thyroidectomy group(A),total thyroidectomy with unilateral central lymph node dissection group(B),and total thyroidectomy with lateral central lymph node dissection group(C).We analyse the preoperative and postoperative serum calcium and parathyroid hormone.In three groups,the serum concentrations of the parathyroid hormone and calcium decreased after operation.The difference was statistically significant between in B group and C group(<0.05);The hypoparathyroidism had statistical significance between A group and C group(<0.05).The possibility of hypoparathyroidism and hypocalcemia was increasing with the expansion of the range of operation.Therefore,retain vital recognition of parathyroid gland was very important in the resection of thyroid cancer especially central lymph node dissection.We should reduce the incidence of permanent hypoparathyroidism as far as possible.
本研究旨在检测手术前后甲状旁腺激素及血清钙水平的变化,评估甲状腺全切除术后甲状旁腺功能的影响及治疗情况。回顾性分析172例初次甲状腺全切除术患者,将其分为单纯甲状腺全切除组(A组)、甲状腺全切除加单侧中央区淋巴结清扫组(B组)和甲状腺全切除加双侧中央区淋巴结清扫组(C组)。分析术前及术后血清钙和甲状旁腺激素水平。三组患者术后甲状旁腺激素及钙的血清浓度均下降。B组与C组之间差异有统计学意义(<0.05);A组与C组之间甲状旁腺功能减退有统计学意义(<0.05)。甲状旁腺功能减退和低钙血症的可能性随着手术范围的扩大而增加。因此,在甲状腺癌切除特别是中央区淋巴结清扫术中,对甲状旁腺的保留至关重要。我们应尽可能降低永久性甲状旁腺功能减退的发生率。