甲状腺切除术后暂时性甲状旁腺功能减退的发生情况及其影响因素分析

Logistic analysis the incidence and influencing factors of temporary hypoparathyroidism after thyroidectomy

目的分析甲状腺切除术后暂时性甲状旁腺功能减退的发生情况及其影响因素。方法选取2019年1月至3月四川大学华西医院收治的行甲状腺切除术患者178例,根据术后是否发生暂时性甲状旁腺功能减退将患者分为发生组(n=32)和未发生组(n=146)。查阅两组病例资料,记录并比较两组患者的性别、年龄、手术范围、是否行二次手术、是否行甲状旁腺自体移植、是否行淋巴结清扫及肿瘤大小等。采用Logistic回归分析甲状腺切除术后发生暂时性甲状旁腺功能减退的影响因素。结果两组患者的性别、年龄比较差异无统计学意义(P>0.05);两组患者的手术范围、是否行二次手术、是否行甲状旁腺自体移植、是否行淋巴结清扫及肿瘤大小差异有统计学意义(P<0.05)。Logistic回归分析结果表明:手术范围、是否行二次手术、是否行甲状旁腺自体移植、是否行淋巴结清扫及肿瘤大小是甲状腺切除术后发生暂时性甲状旁腺功能减退的影响因素。结论手术范围、二次手术、甲状旁腺自体移植、淋巴结清扫、肿瘤大小是甲状腺切除术后发生暂时性甲状旁腺功能减退的影响因素,临床上应根据相关影响因素进行针对性干预,以降低术后甲状旁腺功能减退发生率,提高患者的术后生活质量。

Objective To analysis the incidence and influencing factors of temporary hypoparathyroidism after thyroidectomy.Methods One hundred and seventy-eight cases of thyroidectomy in West China Hospital of Sichuan University from January 2019 to March 2019 were selected as the study objects.According to whether there was temporary hypoparathyroidism after operation,they were divided into two groups:the occurrence group(n=32)and the non occurrence group(n=146).Check the data of the two groups of cases,record the sex,age,operation scope,whether to perform secondary operation,whether to perform parathyroid autotransplantation,whether to perform lymph node dissection,and tumor size,etc.Logistic analysis the incidence and influencing factors of temporary hypoparathyroidism after thyroidectomy.Results There was no significant difference in gender and age between the two groups(P>0.05);There were significant differences in the scope of operation,whether to perform secondary operation,whether to perform parathyroid autotransplantation,whether to perform lymph node dissection and tumor size between the two groups(P<0.05).The results of logistic analysis show that:the scope of operation,whether to perform secondary operation,whether to perform parathyroid autotransplantation,whether to perform lymph node dissection,and tumor size are the influencing factors of temporary hypoparathyroidism after thyroidectomy.Conclusions The scope of operation,secondary operation,parathyroid autotransplantation,lymph node dissection and tumor size are the influencing factors of temporary hypoparathyroidism after thyroidectomy.Clinical intervention should be carried out according to the relevant influencing factors to reduce the incidence of postoperative hypoparathyroidism and improve the quality of life.