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全甲状腺切除/甲状腺切除术后血清钙和离子钙水平的连续测定用于早期发现低钙血症

Serial Estimation of Serum Calcium and Ionic Calcium Level for Early Detection of Hypocalcemia After Total/Completion Thyroidectomy.

作者信息

Sonkhya Nishi, Agarwal Shubham, Choudhary Mahaveer Prasad, Gupta Nishant

机构信息

Department of Otorhinolaryngology, SMS Medical College, Jaipur, Rajasthan 302004 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3493-3496. doi: 10.1007/s12070-023-04031-6. Epub 2023 Jul 1.

Abstract

Hypocalcemia is an important and common complication following thyroid surgery. The development of postoperative hypocalcemia is likely to be multifactorial in nature. Patients with acute hypocalcemia may present with numbness of the distal extremities, circumoral paresthesia, and/or carpopedal spasm, laryngospasm, seizure and arrhythmias. In most cases, post-thyroidectomy hypocalcemia is temporary, but small percentage (0-12%) are permanent. The present study was a 1-year prospective interventional study conducted at tertiary care center, Jaipur, India. Total 42 patients who underwent thyroidectomy were included in study. Evaluation of Serum and Ionic Calcium Level done Preoperatively and Postoperative at 6, 12, 24 and 48 h and patients who develops hypocalcemia symptoms were recorded and data were analyzed. In our study hypocalcemia was seen in 13 (31%) out of 42 subjects. Ionic calcium in 'All patients' gradually decreased from pre operative 1.28 ± 0.04 mmol/l to 1.14 ± 0.08 mmol/l by 24 h. Highest incidence of hypocalcemia was seen in patients who had Total thyroidectomy + neck dissection (83.3%) compared to other type of thyroid surgery. we concluded that post thyroidectomy transient hypocalcemia is a frequent complication. Serial monitoring of calcium levels preoperatively and postoperatively combined with careful monitoring of signs and symptoms of hypocalcemia is an efficient and cost-effective tool to detect early post thyroidectomy hypocalcemia.

摘要

低钙血症是甲状腺手术后一种重要且常见的并发症。术后低钙血症的发生可能具有多因素性质。急性低钙血症患者可能出现四肢远端麻木、口周感觉异常和/或手足痉挛、喉痉挛、癫痫发作及心律失常。在大多数情况下,甲状腺切除术后的低钙血症是暂时的,但有一小部分(0 - 12%)是永久性的。本研究是在印度斋浦尔的一家三级医疗中心进行的为期1年的前瞻性干预研究。共有42例接受甲状腺切除术的患者被纳入研究。术前以及术后6小时、12小时、24小时和48小时对血清和离子钙水平进行评估,并记录出现低钙血症症状的患者,然后对数据进行分析。在我们的研究中,42名受试者中有13名(31%)出现了低钙血症。“所有患者”的离子钙水平从术前的1.28±0.04 mmol/L逐渐下降,到24小时时降至1.14±0.08 mmol/L。与其他类型的甲状腺手术相比,全甲状腺切除术 + 颈部清扫术的患者低钙血症发生率最高(83.3%)。我们得出结论,甲状腺切除术后短暂性低钙血症是一种常见并发症。术前和术后对钙水平进行连续监测,同时仔细监测低钙血症的体征和症状,是检测甲状腺切除术后早期低钙血症的一种有效且具有成本效益的方法。

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