甲状腺全切术治疗分化型甲状腺癌中应用甲状旁腺保护对患者激素水平的影响研究

Effect of Parathyroid Protection on Hormone Levels in Patients with Differentiated Thyroid Carcinoma Treated by Total Thyroidectomy

目的探讨对分化型甲状腺癌患者在甲状腺全切术中应用甲状旁腺保护性操作的临床价值。方法选取2017年8月至2019年10月新疆医科大学第七附属医院收治的分化型甲状腺癌患者114例,按照术中是否接受甲状旁腺保护性操作分为观察组和对照组,每组57例。分别记录两组患者围术期不同时间段的血钙水平、甲状腺旁腺激素水平,并对其低钙血症、甲状旁腺功能减退等并发症的发生情况进行对比。结果观察组患者在术后1 d、7 d、1个月、3个月时的血清钙离子水平均显著高于对照组,组间比较差异有统计学意义(P<0.05);观察组患者在术后1 d、7 d、1个月、3个月时的血清甲状旁腺激素水平均显著高于对照组,组间比较差异有统计学意义(P<0.05);观察组患者低钙血症、甲状旁腺功能减退、永久性甲状旁腺功能受损等并发症的发生率均显著低于对照组,组间比较差异有统计学意义(P<0.05)。结论在分化型甲状腺癌患者行甲状腺全切术中应用甲状旁腺保护性操作,可有效降低对患者甲状旁腺功能的影响,减少术后低钙血症、甲状旁腺功能减退等并发症的发生风险,对于此类患者的术后康复具有十分重要的作用。

Objective To explore the clinical value of parathyroid protective operation in patients with differentiated thyroid carcinoma during total thyroidectomy.Methods Totally 114 patients with differentiated thyroid cancer admitted in the Seventh Affiliated Hospital of Xinjiang Medical University from August 2017 to October 2019 were selected,according to whether they received parathyroid protective operation during the operation and divided into an observation group and a control group,there were 57 cases in each group.During the perioperative period,the patient's blood calcium level and parathyroid hormone levels were observed,and the occurrence of complications such as hypocalcemia and hypoparathyroidism were observed and recorded.Results The serum calcium levels of the observation group were significantly higher than those of the control group at 1 d,7 d,1 month,and 3 months postoperatively,and the difference between groups was statistically significant(P<0.05).The patients in group 1 had significantly higher levels of serum parathyroid hormone at 1 d,7 d,1 month,and 3 months after operation,and the difference between groups was statistically significant(P<0.05).The observation group The incidence of hypocalcemia,hypoparathyroidism,and permanently impaired parathyroid function in the patients were significantly lower than those in the control group,and the difference between groups was statistically significant(P<0.05).Conclusion Protective operation of parathyroid gland during total thyroidectomy in patients with differentiated thyroid cancer can effectively reduce the impact on parathyroid function,reduce the risk of postoperative hypocalcemia and hypoparathyroidism,such patients have a very important role in postoperative rehabilitatione.