甲状腺切除术后低钙血症的危险因素：系统评价和荟萃分析。
Risk factors for postoperative hypocalcaemia after thyroidectomy: A systematic review and meta-analysis.
机构信息
Department of Nursing, Second Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang Province, China.
Department of Nursing, School of Medicine, Huzhou University, Huzhou, Zhejiang Province, China.
出版信息
J Int Med Res. 2021 Mar;49(3):300060521996911. doi: 10.1177/0300060521996911.
OBJECTIVE
A meta-analysis to investigate the risk factors for postoperative hypocalcaemia after thyroidectomy in adult patients.
METHODS
A systematic search of publications in the electronic databases (PubMed®, The Cochrane Library, Web of Science, OVID and Embase®) from inception to June 2020 was conducted. Screening of titles, abstracts and full texts and data extraction were independently performed by two authors. The OR was selected as the pooled estimate.
RESULTS
The analysis included 23 studies. Twelve significant risk factors for postoperative hypocalcaemia were identified: hypoparathyroidism, OR 5.58; total thyroidectomy, OR 3.59; hypomagnesaemia, OR 2.85; preoperative vitamin D deficiency, OR 2.32; female sex, OR 1.49; thyroid malignancy, OR 1.85; thyroiditis, OR 1.48; substernal multinodular goitres, OR 1.70; parathyroidectomy, OR 1.58; central compartment neck dissection, OR 1.17; modified radical neck dissection, OR 1.57; and central neck dissection, OR 1.54.
CONCLUSIONS
This meta-analysis provides moderate-to-high quality evidence that the 12 risk factors were predictive of postoperative hypocalcaemia, which should be monitored closely before thyroidectomy.
目的
进行荟萃分析，以调查成年患者甲状腺切除术后低钙血症的危险因素。
方法
系统检索了从开始到 2020 年 6 月发表在电子数据库（PubMed®、Cochrane 图书馆、Web of Science、OVID 和 Embase®）中的文献。两名作者独立进行了标题、摘要和全文的筛选以及数据提取。选择 OR 作为汇总估计值。
结果
该分析纳入了 23 项研究。确定了 12 个与术后低钙血症相关的显著危险因素：甲状旁腺功能减退症，OR 5.58；甲状腺全切除术，OR 3.59；低镁血症，OR 2.85；术前维生素 D 缺乏症，OR 2.32；女性，OR 1.49；甲状腺恶性肿瘤，OR 1.85；甲状腺炎，OR 1.48；胸骨后多结节性甲状腺肿，OR 1.70；甲状旁腺切除术，OR 1.58；中央区颈部清扫术，OR 1.17；改良根治性颈部清扫术，OR 1.57；中央颈部清扫术，OR 1.54。
结论
这项荟萃分析提供了中等至高质量的证据，表明这 12 个危险因素可预测术后低钙血症，在甲状腺切除术之前应密切监测。
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