甲状腺全切及次全切术中甲状旁腺及血供的保护

Preservation of parathyroid glands and its artery blood supply during total and subtotal thyroidectomy

目的探讨甲状腺全切及近全切术中甲状旁腺及其血供保护对其功能影响。方法对98例行甲状腺全切、次全切除术在术中显露保护甲状旁腺,避免结扎甲状腺下动脉主干,观察术后甲状旁腺功能情况。结果术后38例出现甲状旁腺功能低下,60例甲状旁腺功能正常。术前结扎甲状腺下动脉组血钙浓度与未结扎组相比差异无显著性,术后差异有显著性(P<0.05或0.01);误切甲状旁腺组与保留组相比术前差异无显著性,但术后差异有显著性(P<0.05或0.01)。结论甲状腺全切及近全切术中辨认和保护甲状旁腺及其血液供应,可有效防止术后甲状旁腺功能低下的发生。

Objective To investigate the effects of preservation of parathyroid glands and its artery blood supply on its function during total and subtotal thyroidectomy.Methods 98 patients underwent total thyroidectomy or subtotal thyroidectomy.During operation,the parathyroid glands were exposed and preserved,and the trunk of inferior thyroid arteries were avoided to ligate.After operation,the parathyroid function was observed.Results 38 patients presented witth hypoparathyroidism after thyroidectomy,60 patients with normal function.Before operation,the blood concentrations in patients received ligating the trunk of inferior thyroid arteries were almost the same compared to those without ligating the arteries,there was no statistical difference,but after operation,there was statistical difference（P〈0.05 or 0.01）.Conclusion During total or subtotal thyroidectomy,parathyroid glands and its artery blood-supply should be exposed and preserved to prevent hypoparathyroidism after surgery.