甲状腺手术中甲状旁腺的保护及术后低血钙的处理

The Protection of Parathyroid Gland and the Treatment of Hypocalcemia after Thyroidectomy

目的分析甲状腺手术过程中对甲状旁腺的保护方法及术后低钙血症的处理方法。方法选取313例甲状腺患者作为研究对象,均实施手术治疗,分析不同手术方式出现低钙血症的发生率。结果术后出现低钙血症患者共50例,其中全甲状腺切除7例,全甲状腺切除加中央区淋巴结清扫术33例,双侧腺叶次全切术9例,单侧腺叶切除加中央区淋巴结清扫术1例。所有出现症状的患者均给予钙剂及骨化三醇治疗,病情均得到了有效的控制。结论全甲状腺切除及中央区淋巴结清扫是引起甲状旁腺损伤的重要因素,大多数术后低钙血症是暂时性的,预后良好。

Objective To analyze the protection method of parathyroid during thyroid surgery and processing method of Postoperative hypocalcemia.Methods Select 313 thyroid patients as the subjects,who were treated with surgery.Analyze the incidence of hypocalcemia appears in different surgical methods.Results 50 patients had hypocalcemia after the operation,total thyroidectomy occurred in 7 patients,total thyroidectomy combined with central lymph node dissection occurred in 33 cases,bilateral lobe subtotal resection occurred in 9 cases,unilateral thyroidectomy and central lymph node dissection occurred in 1 case.All patients with symptoms were treated with calcium and Calcitriol.The condition has been effectively controlled.Conclusions Total thyroidectomy and central lymph node dissection are important causes of parathyroid injury.Most of the postoperative hypocalcemia is temporary,the prognosis is good.