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近全甲状腺切除术和全甲状腺切除术患者术后低钙血症的发生率及处理研究

A Study of Incidence and Management of Postoperative Hypocalcemia in Patients Undergoing Near-Total and Total Thyroidectomy.

作者信息

Rao Kartika, Upadhya Ila

机构信息

Mumbai, Maharashtra India.

Department of E.N.T., B.J. Medical College, Ahmedabad, Gujarat India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Apr;76(2):1903-1909. doi: 10.1007/s12070-023-04443-4. Epub 2024 Jan 10.

Abstract

To study the incidence and management of postoperative hypocalcemia in participants undergoing near-total (NTT) and total thyroidectomy (TT) at a tertiary health care center. This is an observational prospective study. Patients posted for NTT and TT in our institute and meeting the inclusion criteria were included. A total of 45 participants were enrolled. The serum calcium was measured on postoperative day 2, at the time of discharge and on 3 months follow-up. A combination of injectable and oral calcium supplements with or without vitamin D sachet was used for the treatment of hypocalcemia. Hypocalcemia was observed in 49% cases. Women were observed to develop hypocalcemia at a higher rate than men. Incidence of hypocalcemia was more in TT patients than NTT patients. Cases with malignant pathology were more susceptible to develop hypocalcemia than those with benign pathology. Operated TT with concomitant neck dissection were at higher risk for development of hypocalcemia. There was no significant association between age and incidence of hypocalcemia. Serum calcium measured on postoperative day 2 was a reliable indicator of risk of hypocalcemia. The early measurement of serum calcium level is a reliable indicator of the risk of hypocalcemia. Standardized treatment of hypocalcemic patients with calcium and vitamin D supplements can reduce the incidence and morbidity associated with postoperative hypocalcemia.

摘要

在一家三级医疗保健中心,研究接受近全甲状腺切除术(NTT)和全甲状腺切除术(TT)的参与者术后低钙血症的发生率及处理情况。这是一项观察性前瞻性研究。纳入了在我们研究所接受NTT和TT且符合纳入标准的患者。共招募了45名参与者。在术后第2天、出院时及3个月随访时测量血清钙。采用注射用和口服钙剂联合或不联合维生素D包进行低钙血症的治疗。49%的病例观察到低钙血症。观察到女性发生低钙血症的比例高于男性。TT患者低钙血症的发生率高于NTT患者。恶性病理的病例比良性病理的病例更容易发生低钙血症。接受TT并同时进行颈部清扫的患者发生低钙血症的风险更高。年龄与低钙血症的发生率之间无显著关联。术后第2天测量的血清钙是低钙血症风险的可靠指标。血清钙水平的早期测量是低钙血症风险的可靠指标。用钙剂和维生素D补充剂对低钙血症患者进行标准化治疗可降低术后低钙血症的发生率及发病率。

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Postoperative hypocalcemia: assessment timing.术后低钙血症:评估时机。
Int J Surg. 2014;12 Suppl 1:S95-7. doi: 10.1016/j.ijsu.2014.05.042. Epub 2014 May 22.

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