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全甲状腺切除术后慢性甲状旁腺功能减退症的高发病率。

High incidence of chronic hypoparathyroidism secondary to total thyroidectomy.

作者信息

Jørgensen Camilla Uhre, Homøe Preben, Dahl Morten, Hitz Mette Friberg

出版信息

Dan Med J. 2020 May 1;67(5):A11190647.

Abstract

INTRODUCTION

Hypoparathyroidism (HypoPT) is the most common complication after total thyroidectomy (TT). Recent literature report incidences of HypoPT that are higher than previously anticipated. This study aimed to assess the incidence of transient and chronic HypoPT in patients undergoing TT and to specify risk factors and recovery time.

METHODS

This was a retrospective review of patients undergoing TT in the period from 2013 to 2018 due to benign thyroid disease in a Danish university hospital. In total, 187 patients were eligible for inclusion. Data were collected from internal medical files, the Thykir database sheets and patient records. HypoPT was defined as SE-ionised-Ca2+ levels (Less than 1.16 mmol/l) and inappropriately low parathyroid hormone levels.

RESULTS

The incidence of transient and chronic HypoPT was 81 (43.3%) and 25 (13.4%), respectively. Younger ages and toxic indication for surgery were independent risk factors for transient and chronic HypoPT. Incidences in Graves' disease population were 70.5% and 27.3%, respectively. Resolution within the first months was seen in 48.2% of the patients with acute transient HypoPT.

CONCLUSIONS

The incidence of chronic HypoPT after TT is higher than previously reported. This is primarily due to a lack of consistency in the definition and follow-up time between studies. Younger patients and those with a toxic indication for surgery are at higher risk of HypoPT after TT than other patients.

FUNDING

none.

TRIAL REGISTRATION

The study was approved by the Danish Data Protection Agency (REG-015-2019) and The Ethical Committee of Central Denmark (No. 66792).

摘要

引言

甲状旁腺功能减退症(HypoPT)是全甲状腺切除术后(TT)最常见的并发症。最近的文献报道的HypoPT发病率高于先前预期。本研究旨在评估接受TT手术患者中短暂性和慢性HypoPT的发病率,并明确危险因素和恢复时间。

方法

这是一项对2013年至2018年期间因良性甲状腺疾病在丹麦一家大学医院接受TT手术患者的回顾性研究。共有187例患者符合纳入标准。数据从内科病历、Thykir数据库表格和患者记录中收集。HypoPT定义为血清离子钙(SE-ionised-Ca2+)水平低于1.16 mmol/l且甲状旁腺激素水平异常降低。

结果

短暂性和慢性HypoPT的发病率分别为81例(43.3%)和25例(13.4%)。年龄较小和手术的毒性指征是短暂性和慢性HypoPT的独立危险因素。格雷夫斯病患者中的发病率分别为70.5%和27.3%。48.2%的急性短暂性HypoPT患者在最初几个月内恢复。

结论

TT术后慢性HypoPT的发病率高于先前报道。这主要是由于各研究之间在定义和随访时间上缺乏一致性。年轻患者和有手术毒性指征的患者在TT术后发生HypoPT的风险高于其他患者。

资金来源

无。

试验注册

该研究获得丹麦数据保护局(REG-015-2019)和丹麦中部伦理委员会(第66792号)批准。

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