甲状腺切除术后患者的低镁血症：一个被低估的问题。
Hypomagnesemia in Post Thyroidectomy Patient: An Underestimated Entity.
作者信息
Radhakrishnan Abhishekh, Chauhan Ishan, Thakur J S, Azad Ramesh, Dhadwal Madhuri
机构信息
Department of ENT-Head and Neck Surgery IGMC, Shimla, Himachal Pradesh India.
出版信息
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1986-1991. doi: 10.1007/s12070-023-03777-3. Epub 2023 Apr 24.
BACKGROUND
In post thyroidectomy patients hypocalcemia is one of the known complication many factors play important role in calcium hemostasis and magnesium is one among them. So this study was conducted to assess the prevalence of hypomagnesemia in post thyroidectomy patients and its relationship with calcium homeostasis.
MATERIALS AND METHODS
A prospective observational study was conducted among 31 patients who underwent total thyroidectomy or completion thyroidectomy over a period of 1 year. Patient's pre-operative and post-operative day 1 and day 2 serum calcium, magnesium and iPTH was recorded and their correlation was analyzed using SPSS 21.0. and value of < 0.05 was taken as statistically significant. Calcium supplementation was only given to patients who developed symptomatic hypocalcemia in postoperative period.
RESULTS
In our study hypomagnesemia in post thyroidectomy patients on post -operative day 1 and day 2 was 71% and 74.2% respectively. Hypocalcemia was seen in 64.5% of patients on post-operative day 1 and 96.8% on post-operative day 2. Symptomatic hypocalcemia was seen in 22.6% of study population on post-operative day 1 and 22.6% of patients on post-operative day 2 while 25.8% patients newly developed symptoms of hypocalcemia. Statistically significant correlation was found between calcium and magnesium levels in post op day 1(< 0.001) and post op day 2(< 0.004) and also statistically significant correlation was found between post-operative day 1 magnesium levels and post-operative day 2 calcium levels (0.001). Symptomatic hypocalcemia was more commonly seen among patients who had hypomagnesemia along with hypocalcemia though it failed to show any statistical significance.
CONCLUSION
Post thyroidectomy hypomagnesemia is frequent event and magnesium acts as an independent risk factor in development of post thyroidectomy hypocalcemia. Hypomagnesemia tends to alleviate symptomatic hypocalcemia in post thyroidectomy patients. So the role of magnesium correction to alleviate severe hypocalcemia needs to be further studied.
背景
在甲状腺切除术后患者中，低钙血症是一种已知的并发症，许多因素在钙稳态中起重要作用，镁是其中之一。因此，本研究旨在评估甲状腺切除术后患者低镁血症的患病率及其与钙稳态的关系。
材料与方法
对31例在1年内接受全甲状腺切除术或甲状腺次全切除术的患者进行了一项前瞻性观察研究。记录患者术前、术后第1天和第2天的血清钙、镁和iPTH水平，并使用SPSS 21.0分析它们之间的相关性。P值<0.05被认为具有统计学意义。仅对术后出现症状性低钙血症的患者给予补钙治疗。
结果
在我们的研究中，甲状腺切除术后患者术后第1天和第2天的低镁血症发生率分别为71%和74.2%。术后第1天64.5%的患者出现低钙血症，术后第2天为96.8%。术后第1天22.6%的研究人群出现症状性低钙血症，术后第2天为22.6%，而25.8%的患者新出现低钙血症症状。术后第1天（<0.001）和术后第2天（<0.004）钙和镁水平之间存在统计学显著相关性，术后第1天镁水平与术后第2天钙水平之间也存在统计学显著相关性（0.001）。症状性低钙血症在同时患有低镁血症和低钙血症的患者中更为常见，尽管未显示出任何统计学意义。
结论
甲状腺切除术后低镁血症是常见事件，镁是甲状腺切除术后低钙血症发生的独立危险因素。低镁血症倾向于减轻甲状腺切除术后患者的症状性低钙血症。因此，纠正镁以减轻严重低钙血症的作用需要进一步研究。
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