甲状腺癌根治术后甲状旁腺功能减退的影响因素分析

The influencing factors of parathyroid function impairment after thyroid cancer radical

目的：探讨甲状腺癌根治术后甲状旁腺功能减退的影响因素。方法：收集92例甲状腺癌根治术患者临床资料,根据术后是否出现甲状旁腺功能减退分为减退组和未减退组,比较2组年龄、性别、临床分期、手术方式、是否自体甲状旁腺移植、是否Ⅵ区淋巴结清扫等差异,非条件多因素logistic回归分析甲状腺癌根治术后甲状旁腺功能减退的影响因素。结果：28例发现甲状旁腺功能减退,发生率为30.43%。单因素分析显示,2组年龄、性别、临床分期差异均无统计学意义（P〉0.05）;减退组手术方式为甲状腺全切、有自体甲状旁腺移植以及有Ⅵ区淋巴结清扫患者均高于未减退组（P〈0.05~P〈0.01）。非条件多因素logistic回归分析结果显示,手术方式、Ⅵ区淋巴结清扫均是甲状腺癌根治术后甲状旁腺功能减退的危险因素（OR值分别为3.317、2.183）。结论：甲状腺癌根治术患者行Ⅵ区淋巴结清扫以及选择甲状腺全切术式术后甲状旁腺功能减退的风险显著增加。

Objective：To explore the influencing factors of parathyroid function impairment after thyroid cancer radical. Methods：The clinical data of 92 cases patients with thyroid cancer radical from September 2010 to October 2015 in hospital surgical were collected, they were divided into decline group and no decline group according to whether the postoperative parathyroid function, the age, sex, clinical staging, operation mode, whether parathyroid autograft,whether sponsored by the lymph node in Vlarea were compared between two groups, the influencing factors of parathyroid function impairment after thyroid cancer radical was analyzed by multiariable Logistic regression analysis. Results：There were 28 cases patients with parathyroid function impairment among 92 cases patients with thyroid cancer radical,the incidence was 30.43%. Single factor analysis showed that the differences of age ,sex,clinical stage had no statistical significance between two groups （ P 〉 0.05 ） ; Cognitive impairment operation method for thyroid full cut, parathyroid autograft and sponsored by the lymph node area ratio were higher than patients with cognitive impairment （ P 〈 0.05 to P 〈 0.01 ）. Unconditioned multiariable logistic regression analysis showed that the operation way, behold, the lymph node zone were risk factors of parathyroid function impairment after thyroid cancer radical （OR values were respectively 3. 317,2. 183 ）. Conclusions：The risk of parathyroid function impairment after thyroid cancer radical increased significantly in those patients with lymph node cleaning at VI area and thyroid fuU cut.