Department of General Surgery, Fırat University Medical Faculty Hospital, Turkey.
Department of General Surgery, Erciyes University Medical Faculty Hospital, Turkey.
Asian J Surg. 2019 Sep;42(9):883-889. doi: 10.1016/j.asjsur.2018.12.009. Epub 2019 Jan 23.
The most common complication after thyroid surgery is hypocalcaemia and it sometimes leads to problems that are difficult to correct in patients. The present study was aimed to determine the risk factors causing the development of hypocalcaemia after thyroid surgery.
818 adult patients were included in the study. The data were recorded by examining the hospital automation system and patient files retrospectively. Patients' demographic characteristics, radiological imaging findings, serum biochemical parameters, extent of the performed surgery, histopathological diagnoses were recorded.
The rate of hypocalcaemia was 28.4% (1.7% permanent). In multivariate analysis: the female gender (p = 0.002), heavier thyroid gland (p = 0.084), substernal location (p = 0.004) and cervical lymph nodes dissection (CLND) (p < 0.001) were found to be significantly. Malignant thyroid pathology (p = 0.006) and total thyroidectomy (p = 0.025) increased the risk of hypocalcaemia significantly in univariate analysis. However, this increase in risk was not found to be statistically significant in regression analysis. Significant statistical result was not found on postoperative hypocalcaemia in terms of advanced age, hyperthyroidism and re-operation. The duration of hospitalization was higher in patients with postoperative hypocalcaemia (m = 2 days) (p < 0.001).
In our analyses CLND, female gender, substernal location and heavier thyroid gland was found to be the independent risk factors in the development of postoperative hypocalcaemia. The development of postoperative hypocalcaemia may be predicted and measures may be taken to prevent clinical findings.
甲状腺手术后最常见的并发症是低钙血症,有时会导致患者难以纠正的问题。本研究旨在确定导致甲状腺手术后低钙血症发生的危险因素。
纳入 818 例成年患者,通过回顾性检查医院自动化系统和患者档案记录数据。记录患者的人口统计学特征、影像学表现、血清生化参数、手术范围、组织病理学诊断。
低钙血症发生率为 28.4%(1.7%为永久性)。多因素分析显示:女性(p=0.002)、甲状腺较大(p=0.084)、胸骨后位置(p=0.004)和颈部淋巴结清扫术(CLND)(p<0.001)与低钙血症显著相关。恶性甲状腺病理(p=0.006)和全甲状腺切除术(p=0.025)在单因素分析中显著增加了低钙血症的风险。然而,在回归分析中,这种风险增加并不具有统计学意义。在高龄、甲亢和再次手术方面,术后低钙血症的发生并没有显著的统计学结果。术后低钙血症患者的住院时间更长(m=2 天)(p<0.001)。
在我们的分析中,CLND、女性、胸骨后位置和更大的甲状腺被认为是术后低钙血症发生的独立危险因素。术后低钙血症的发生可以预测,并采取措施预防临床发现。