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[甲状腺切除术后甲状旁腺功能减退症。近期连续病例系列分析]

[Hypoparathyroidism after thyroidectomy. Analysis of a consecutive, recent series].

作者信息

Pelizzo M R, Bernante P, Toniato A, Piotto A, Grigoletto R

机构信息

Istituto di Chirurgia Generale I, Università degli Studi, Padova.

出版信息

Minerva Chir. 1998 Apr;53(4):239-44.

PMID:9701977
Abstract

We analyzed a recent and consecutive series of 254 thyroidectomies performed during the last year to verify the incidence of post-thyroidectomy hypoparathyroidism. 249 patients were included in the study and were divided into 2 groups according to the extension of the thyroidectomy. In the first group of 49 patients treated by lobectomy no one developed hypoparathyroidism. In the second group of 200 patients, of which 53 were treated by subtotal and 147 by total thyroidectomy, postoperative hypoparathyroidism was found in 28 (14%) patients, but it was persistent (lasting six months or longer) in 8 (4%). Global incidence of postoperative hypoparathyroidism was statistically higher in total thyroidectomy vs subtotal thyroidectomy (17% vs 5.66%; p < 0.05); however persistent hypoparathyroidism incidence wasn't statistically higher in total thyroidectomy (5.4% vs 0%; p = n.s.). As far as thyroid disorders that require bilateral thyroidectomy Chi 2-test showed a trend of persistent hypoparathyroidism to be more frequent in patients operated on for Graves' disease and thyroid cancer than in other thyroid disorders.

摘要

我们分析了去年进行的最近连续的254例甲状腺切除术系列病例,以核实甲状腺切除术后甲状旁腺功能减退症的发生率。249例患者纳入研究,并根据甲状腺切除术的范围分为2组。在第一组49例行叶切除术的患者中,无人发生甲状旁腺功能减退症。在第二组200例患者中,53例行次全甲状腺切除术,147例行全甲状腺切除术,术后28例(14%)患者发生甲状旁腺功能减退症,但8例(4%)患者为持续性(持续6个月或更长时间)。全甲状腺切除术术后甲状旁腺功能减退症的总体发生率在统计学上高于次全甲状腺切除术(17%对5.66%;p<0.05);然而,全甲状腺切除术持续性甲状旁腺功能减退症的发生率在统计学上并无更高(5.4%对0%;p=无显著性差异)。就需要双侧甲状腺切除术的甲状腺疾病而言,卡方检验显示,与其他甲状腺疾病相比,因格雷夫斯病和甲状腺癌接受手术的患者持续性甲状旁腺功能减退症更为常见。

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