分化型甲状腺癌甲状腺全切术中应用甲状旁腺保护性操作对术后甲状旁腺激素、血清钙离子的影响

Effect of parathyroid protection on parathyroid hormone and serum calcium in patients with differentiated thyroid carcinoma total thyroidectomy

目的探讨分化型甲状腺癌(DTC)患者采用甲状腺全切术中应用甲状旁腺保护性操作对患者血清甲状旁腺激素、血清钙离子水平的影响。方法回顾性选取2014年1月-2016年12月治疗的120例患者进行研究,根据治疗方法分为保护组和常规组,各60例,对比2组患者术前、术后各时间点甲状旁腺激素、血钙水平、甲状旁腺功能减退、低钙血症、永久性甲状旁腺功能受损的发生率。结果术前保护组和常规组患者的血清甲状旁腺激素、钙离子差异无统计学意义(P>0.05);术后1 d、术后第3 d、术后第7 d、术后1个月,保护组血清甲状旁腺激素、钙离子水平高于常规组;术后1个月,保护组甲状旁腺功能减退、低钙血症发生率低于常规组,差异均有统计学意义(P<0.05)。结论 DTC患者采用甲状腺全切术中应用甲状旁腺保护性操作可减少对甲状旁腺的损害,降低术后发生甲状旁腺功能减低及低钙血症的发生率。

Objective To investigate the effect of parathyroid protective operation on thyroid parathyroid hormone and serum calcium level in patients undergoing total thyroidectomy in differentiated thyroid carcinoma（ DTC） patients. Methods A retrospective study was conducted on 120 patients treated from January 2014 to December 2016,according to the treatment method,which were divided into the protection group and the conventional group,with 60 cases in each group,the incidence rates of parathyroid hormone,hypocalcemia,parathyroid dysfunction,hypocalcemia and permanent parathyroid function were compared between the two groups before and after operation. Results Before operation,there was no statistical significance on the differences of serum parathyroid hormone and calcium between the two groups（ P 〉 0. 05）; the levels of serum parathyroid hormone and calcium in the protective group were higher than those in the conventional group at 1 d,3 d,7 d and 1 month after operation. 1 month after the operation,hypoparathyroidism,hypocalcemia rates of the protection group were lower than the conventional group,with the differences statistically significant（ P 〈0. 05）. Conclusion DTC patients accepting parathyroid protective operation in total thyroidectomy can reduce the damage of parathyroid thyroidectomy,and reduce postoperative parathyroid dysfunction and the incidence of hypocalcemia.