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甲状腺手术中意外甲状旁腺切除的危险因素分析:对1775例患者的回顾性分析

The analysis of risk factors for accidental parathyroid resection during thyroid surgery: a retrospective analysis of 1775 patients.

作者信息

Li-Yong Zhang, Bo-Yan Liang, Qing Zhou, Shao-Jun Cai, ShouYi Yan, Bo Wang, Wen-Xin Zhao

机构信息

Department of General Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.

Department of Thyroid Surgery, Minimal Invasive Center, The Training Center for Intraoperative neurophysiologic monitoring (IONM) of Thyroid and Parathyroid, Fujian Medical University Union Hospital, Fuzhou, China.

出版信息

Surg Today. 2023 Apr;53(4):451-458. doi: 10.1007/s00595-022-02584-7. Epub 2022 Sep 13.

Abstract

PURPOSE

The present study discussed the effects of accidental parathyroid resection on hypoparathyroidism and investigated the risk factors associated with accidental parathyroid resection.

METHODS

Clinical data from patients who have undergone thyroidectomy at a university hospital in the period from November 2018 and October 2020 were entered into the database and analyzed. Risk factors for accidental parathyroid resection were recorded.

RESULTS

A total of 1775 cases were included in this study. The analysis showed that lymph-node dissection (p < 0.001), T staging (p = 0.037), and treatment group (p < 0.001) were independent risk factors for accidental parathyroid resection. Different treatment groups were important risk factors for accidental parathyroid resection. There were significant differences between the professional and non-professional groups in the following aspects: accidental parathyroid resection (p < 0.001), Scope (p < 0.001), T stage (p = 0.009), N stage (p < 0.001), range of lymph-node dissection (p < 0.001), number of lymph nodes dissected in central area (p < 0.001), and number of lymph-node metastases in the central region (p < 0.001).

CONCLUSIONS

The causes of accidental parathyroid resection are multifactorial. The predictors for accidental parathyroid resection include lymph-node dissection in the central region, T staging, as well as the operating surgeons' experience.

摘要

目的

本研究探讨意外甲状旁腺切除对甲状旁腺功能减退的影响,并调查与意外甲状旁腺切除相关的危险因素。

方法

将2018年11月至2020年10月期间在某大学医院接受甲状腺切除术的患者的临床资料录入数据库并进行分析。记录意外甲状旁腺切除的危险因素。

结果

本研究共纳入1775例病例。分析表明,淋巴结清扫(p<0.001)、T分期(p = 0.037)和治疗组(p<0.001)是意外甲状旁腺切除的独立危险因素。不同治疗组是意外甲状旁腺切除的重要危险因素。专业组和非专业组在以下方面存在显著差异:意外甲状旁腺切除(p<0.001)、范围(p<0.001)、T分期(p = 0.009)、N分期(p<0.001)、淋巴结清扫范围(p<0.001)、中央区清扫淋巴结数量(p<0.001)以及中央区淋巴结转移数量(p<0.001)。

结论

意外甲状旁腺切除的原因是多因素的。意外甲状旁腺切除的预测因素包括中央区淋巴结清扫、T分期以及手术医生的经验。

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