Chincholikar Shrikanth P, Ambiger Sudha
Department of Surgery, Bidar Institute of Medical Science, Bidar, Karnataka, India.
Department of Biochemistry, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Indian J Endocrinol Metab. 2018 Sep-Oct;22(5):656-660. doi: 10.4103/ijem.IJEM_599_17.
Hypocalcemia is one of the most common acceptable complications in postoperative period after thyroidectomy. Hypomagnesemia has been recognized after parathyroid surgery, and it has not been studied extensively after thyroidectomy. The aim of this study was to estimate magnesium and calcium ion levels in patients undergoing thyroidectomy and to evaluate the association of hypomagnesemia with hypocalcemia after thyroidectomy. A prospective study was conducted in Government Medical College, Calicut, from December 2012 to November 2013.
all patients had undergone total/near-total/subtotal thyroidectomy. Pre- and postoperative at 24 h and serum calcium and magnesium were measured by automate electrolyte analyzer. Clinical findings of hypocalcemia were recorded. Statistical analysis was done using SPSS software, version 17.0. Unpaired student -test was used. Pearson Chi-square test or Fisher's exact test was used to compare the percentage for categorical variables.
In our study, 58% of the patients developed hypocalcemia, biochemical and/or symptomatic (S. Ca <8.5). About 34% of patients developed hypomagnesemia, biochemical and/or symptomatic (S. Mg <1.7). About 30% of patients developed both hypocalcemia and hypomagnesemia. About 24% of patients developed symptoms of both hypocalcemia and hypomagnesemia.
Thyroidectomy patients were at a risk of transient and permanent hypoparathyroidism because of chances of parathyroid resection during operation. Transient hypocalcemia and hypomagnesemia occur frequently after total thyroidectomy. It is important to monitor both calcium and magnesium levels after total thyroidectomy and to correct deficiencies to facilitate prompt resolution of symptoms.
There is an association of hypomagnesemia with hypocalcemia after thyroidectomy.
低钙血症是甲状腺切除术后最常见的可接受并发症之一。甲状旁腺手术后已认识到低镁血症,但甲状腺切除术后尚未对此进行广泛研究。本研究的目的是评估甲状腺切除患者的镁离子和钙离子水平,并评估甲状腺切除术后低镁血症与低钙血症的相关性。2012年12月至2013年11月在科泽科德政府医学院进行了一项前瞻性研究。
所有患者均接受了全/近全/次全甲状腺切除术。术前及术后24小时采用自动电解质分析仪测定血清钙和镁。记录低钙血症的临床表现。使用SPSS 17.0软件进行统计分析。采用非配对学生t检验。使用Pearson卡方检验或Fisher精确检验比较分类变量的百分比。
在我们的研究中,58%的患者出现了低钙血症,包括生化性和/或症状性(血清钙<8.5)。约34%的患者出现了低镁血症,包括生化性和/或症状性(血清镁<1.7)。约30%的患者同时出现了低钙血症和低镁血症。约24%的患者出现了低钙血症和低镁血症的症状。
由于手术中甲状旁腺有被切除的可能性,甲状腺切除患者有发生暂时性和永久性甲状旁腺功能减退的风险。全甲状腺切除术后经常出现暂时性低钙血症和低镁血症。全甲状腺切除术后监测钙和镁水平并纠正缺乏以促进症状迅速缓解很重要。
甲状腺切除术后低镁血症与低钙血症有关联。