甲状腺手术中甲状旁腺显露及功能保护的临床价值

Clinical Value of Parathyroid Gland Exposure and Function Protection During Thyroid Surgery

目的分析甲状腺手术对甲状旁腺显露的效果以及如何对其功能进行保护。方法选取我院2016年12月—2017年12月所收治的行甲状腺手术患者100例,采用奇偶法分为试验组和参照组,每组各50例,参照组在手术过程当中未对甲状旁腺进行刻意显露,仅给予常规保护,试验组在手术当中显露甲状旁腺及血供保护,对比两组手术前后甲状旁腺素与血清钙水平、低钙血症发生率。结果试验组与参照组手术前甲状旁腺素与血清钙水平对比差异无统计学意义(P> 0.05),手术后两组患者对比差异有统计学意义(P <0.05);试验组低钙血症发生3例,占总比6%,参照组低钙血症发生14例,占总比28%,组间对比差异有统计学意义(P <0.05)。结论临床甲状腺手术过程当中,极易导致患者甲状旁腺腺体及其血供出现损伤情况,因此在实际手术过程当中对其甲状旁腺及血供进行充分显露,能够对患者甲状旁腺功能进行全面保护,从而降低患者低钙血症发生率。

Objective To analyze the effect of parathyroid gland exposure during thyroid surgery and the way how to protect its function.Methods 100 patients who underwent thyroid surgery in our hospital from December 2016 to December 2017 were selected and divided into experimental group and control group through parity method,with 50 patients in each group.The parathyroid glands were not exposed deliberately and only provided with regular protection during thyroid surgery in control group,while the parathyroid glands were exposed and provided with blood supply protection in experimental group,then the levels of parathyroid hormone and serum calcium,the incidence of hypocalcemia was compared between two groups before and after surgery.Results There was no significant difference in the preoperative level of parathyroid adenine and serum calcium between the experimental group and the control group(P>0.05),but the difference between the two groups was statistically significant after surgery(P<0.05).There were 3 cases of hypocalcemia occurred in the experimental group,accounting for 6%of the total,while 14 cases of hypocalcemia occurred in the control group,accounting for 28%of the total,there was significant dif ference between the two groups(P<0.05).Conclusion During thyroid surgery,the parathyroid gland and its blood supply would be easily damaged,thus the parathyroid gland and blood supply should be fully exposed during the operation,so as to fully protect the parathyroid gland function,thus reducing the incidence of hypocalcemia.