甲状腺切除手术中暴露并保护甲状旁腺的必要性

Necessity of exposure and protection of parathyroid glands during thyroidectomy

目的探讨甲状腺切除手术中暴露并保护甲状旁腺的必要性。方法将164例因结节性甲状腺肿和甲状腺癌接受手术治疗的患者根据已完成手术情况分为甲状旁腺暴露组和非暴露组两组。非暴露组76例患者保留甲状腺后被膜,未寻找甲状旁腺;暴露组88例患者寻找并保护甲状旁腺,尽量保证甲状旁腺的血供及完整性。术后进行动态监测血清钙变化,观察甲状旁腺的功能情况。结果在术中寻找并保护甲状旁腺的观察组中,术后甲状旁腺功能低下的发生率较未寻找甲状旁腺的对照组患者明显降低,两组比较差异有统计学意义(P<0.05)。结论在甲状腺切除手术中,寻找并保护甲状旁腺,可以有效的降低术后甲状旁腺功能低下的发生率。

Objective To investigate the necessity of exposing and protecting parathyroid glands during thyroidectomy....Methods A total of 164 cases that underwent surgical treatment for nodulargoiter or thyroid cancer were randomly divided into two groups ,.exposed group and non-exposed group..For non-exposed group. （n=76）,.the posterior capsule of thyroid was reserved and the parathyroid glands were not explored during operation. For exposed group （n=88）,.the parathyroid glands were exposed and protected from devasation..After operation,.the level of serum calcium was monitored and the function of parathyroid glands was tested dynamically....Results Postoperative incidence of hypoparathyroidism in patients with exposing and protecting parathyroid glands was significantly lower than that in patients without exposing and protecting parathyroid glands （P0.05）....Conclusion During thyroidectomy, exposing and protecting the parathyroid glands would effectively decrease the incidence of postoperative hypoparathyroidism.