Graves病患者行全甲状腺切除术后发生术后并发症的风险增加。

Increased risk of postoperative complications after total thyroidectomy with Graves' disease.

作者信息

Kwon Hyungju, Kim Jong-Kyu, Lim Woosung, Moon Byung-In, Paik Nam Sun

机构信息

Department of Surgery, Ewha Womans University Medical Center, Seoul, South Korea.

出版信息

Head Neck. 2019 Feb;41(2):281-285. doi: 10.1002/hed.25484. Epub 2018 Dec 7.

DOI:10.1002/hed.25484

PMID:30537006

Abstract

BACKGROUND

The effect of Graves' disease on the risk of postoperative complications in patients undergoing total thyroidectomy is unclear.

METHODS

The incidence of recurrent laryngeal nerve (RLN) injury and hypoparathyroidism were analyzed between 165 patients with Graves' disease (GD group) and 1:1 matched patients with euthyroid states (control group).

RESULTS

The matched cohorts did not differ in age, sex, body mass index, pathologic diagnosis, and extent of operation. Excised thyroid weight was higher in the Graves' disease than in the control group (60.1 g vs 22.6 g; P < .001). Multivariate analysis showed that Graves' disease significantly increased risks of transient RLN injury (odds ratio [OR] = 4.7, 95% confidence interval [CI] = 1.5-15.5; P = .010) and transient hypoparathyroidism (OR = 2.8, 95% CI = 1.3-5.8; P = .007). Rates of permanent complications were comparable in the Graves' disease and control groups.

CONCLUSIONS

Graves' disease can be a predictive factor for postoperative RLN injury and hypoparathyroidism after total thyroidectomy.

摘要

背景

格雷夫斯病对接受全甲状腺切除术患者术后并发症风险的影响尚不清楚。

方法

分析了165例格雷夫斯病患者（GD组）和1:1匹配的甲状腺功能正常患者（对照组）的喉返神经（RLN）损伤和甲状旁腺功能减退的发生率。

结果

匹配队列在年龄、性别、体重指数、病理诊断和手术范围方面无差异。格雷夫斯病患者切除的甲状腺重量高于对照组（60.1 g对22.6 g；P <.001）。多因素分析显示，格雷夫斯病显著增加了短暂性RLN损伤（比值比[OR]=4.7，95%置信区间[CI]=1.5-15.5；P=.010）和短暂性甲状旁腺功能减退（OR=2.8，95%CI=1.3-5.8；P=.007）的风险。格雷夫斯病组和对照组的永久性并发症发生率相当。