Aagaard J, Blichert-Toft M, Christiansen C
Ann Chir Gynaecol. 1984;73(2):73-7.
Levels of corrected serum calcium, serum free thyroxine index, and serum thyroid stimulating hormone were measured prior to thyroid surgery and 3, 6, 12, 24, and 36 months postoperatively in 18 patients with nontoxic uninodular goitre and in 32 patients with nontoxic multinodular goitre. Additionally, the corrected serum calcium was also determined on the fourth day of surgery. In the former group unilateral resection was done, whilst the latter group had bilateral resection of the thyroid gland. In both goitrous groups, the study demonstrated a slight lowering, albeit significant, of the corrected serum calcium level postoperatively. However, during the study period the mean level of serum calcium was within reference range. Remarkably, there was no significant difference as to change in calcium levels between the two surgical groups. The calcium disturbances were not related to postsurgical thyroid function. Other possible explanations to the change in serum calcium level are discussed, but no responsible mechanism was clarified in the study. It is concluded that although a significant lowering of serum calcium levels takes place after goitre resection, the changes seem not to indicate any therapeutic measures in the long run.
在18例非毒性单结节性甲状腺肿患者和32例非毒性多结节性甲状腺肿患者中,于甲状腺手术前以及术后3、6、12、24和36个月测量校正血清钙、血清游离甲状腺素指数和血清促甲状腺激素水平。此外,还在术后第四天测定校正血清钙。前一组进行单侧切除,而后一组进行双侧甲状腺切除。在两个甲状腺肿组中,研究均显示术后校正血清钙水平有轻微下降,尽管具有统计学意义。然而,在研究期间,血清钙的平均水平在参考范围内。值得注意的是,两个手术组之间钙水平的变化没有显著差异。钙紊乱与术后甲状腺功能无关。文中讨论了血清钙水平变化的其他可能解释,但该研究未阐明其相关机制。结论是,尽管甲状腺肿切除术后血清钙水平会显著降低,但从长远来看,这些变化似乎并不表明需要采取任何治疗措施。