老年甲状腺全切除129例术后并发甲状旁腺功能减退的临床调查

Clinical investigation of 129 elderly patients with hypoparathyroidism after total thyroidectomy

目的探讨老年甲状腺肿瘤全切除术后并发甲状旁腺功能减退的发生情况及相关影响因素。方法选择湖北医药学院附属人民医院于2015年1月至2018年6月收治的老年甲状腺肿瘤病人129例作为研究对象,均行甲状腺全切除术治疗,观察并发甲状旁腺功能减退发生情况。采用多因素logistic回归分析影响术后并发甲状旁腺功能减退危险因素。结果老年甲状腺肿瘤病人129例,术后并发甲状旁腺功能减退35例,发生率为27.13%。经单因素分析表明,两组性别、术前甲状旁腺激素、合并基础疾病、吸烟史、二次手术、颈侧区淋巴结清扫和喉返神经后方淋巴结清扫比较差异无统计学意义(P>0.05);两组肿瘤大小和甲状旁腺误切比较差异有统计学意义(P<0.05)。将上述单因素分析差异有统计学意义的纳入多因素logistic回归分析显示,肿瘤大小和甲状旁腺误切为影响术后并发甲状旁腺功能减退危险因素。结论老年甲状腺肿瘤全切除术后并发甲状旁腺功能减退发生率较高,且受多因素影响,其中肿瘤大小和甲状旁腺误切为其危险因素。

Objective To investigate the incidence and related factors of hypoparathyroidism after total thyroidectomy in elderly patients.MethodsOne hundred and twenty-nine elderly patients with thyroid tumors who admitted to People’s Hospital of Hubei Medical College from January 2015 to June 2018 were selected as the study subjects.All patients underwent total thyroidectomy to observe the occurrence of hypoparathyroidism.Multivariate logistic regression was used to analyze the risk factors of postoperative hypoparathyroidism.ResultsThere were 129 elderly patients with thyroid neoplasms,and 35 patients with hypoparathyroidism after operation.The incidence was 27.13%.Univariate analysis showed that there was no significant difference between the two groups in sex,preoperative parathyroid hormone,combined with underlying diseases,smoking history,secondary surgery,cervical lymph node dissection and posterior lymph node dissection of recurrent laryngeal nerve(P>0.05);there was significant difference in tumor size and parathyroidectomy between the two groups(P<0.05).The statistical significance of the above-mentioned univariate analysis difference was included in logistic regression analysis,the results showed that tumor size and parathyroidectomy were risk factors for postoperative hypoparathyroidism.ConclusionThe incidence of hypoparathyroidism after total thyroidectomy in elderly patients is high,and it is influenced by many factors.Among them,tumor size and parathyroidectomy are the risk factors.