甲状腺切除术后患者甲状旁腺功能减退的发生及其相关影响因素分析

Analysis of the incidence and related factors of hypoparathyroidism after thyroidectomy

目的探讨甲状腺切除术后影响甲状旁腺功能减退的相关因素。方法回顾性分析2018年1月至2020年3月于武汉市新洲区人民医院行甲状腺切除术的150例患者的临床资料,根据术后是否发生甲状旁腺功能减退,分为功能减退组(29例)和功能正常组(121例)。统计甲状腺切除术后患者甲状旁腺功能减退的发生情况,比较功能减退和功能正常患者的临床资料,分析甲状腺切除术后患者甲状旁腺功能减退的危险因素。结果150例甲状腺切除患者术后发生甲状旁腺功能减退共29例(19.33%)。甲状腺包膜受侵、淋巴结清扫、甲状旁腺误切、肿瘤直径>4cm、未应用纳米碳示踪剂、行开放性手术是患者甲状腺切除术后发生甲状旁腺功能减退的危险因素(OR=3.963、3.658、3.281、3.357、3.943、4.187,P<0.05)。结论患者行甲状腺切除术后发生甲状旁腺功能减退的概率较高,其发生甲状旁腺功能减退的危险因素包括甲状腺包膜受侵、淋巴结清扫、甲状旁腺误切、肿瘤直径>4cm、未应用纳米碳示踪剂、行开放性手术,临床可据此给予甲状腺切除术后患者针对性治疗及干预措施,以降低甲状旁腺功能减退的发生风险。

Objective To investigate the related factors of hypoparathyroidism after thyroidectomy.Method The clinical data of 150 patients who underwent thyroidectomy in Wuhan Xinzhou District People's Hospital from January 2018 to March 2020 were analyzed retrospectively.According to whether there was hypoparathyroidism after operation,they were divided into hypoparathyroidism group(29 cases)and normal function group(121 cases).The incidence of hypoparathyroidism after thyroidectomy was counted,the clinical data of patients with hypoparathyroidism and normal function were compared,and the risk factors of hypoparathyroidism after thyroidectomy were analyzed.Result There were 29 cases(19.33%)of hypoparathyroidism in 150 patients after thyroidectomy.Thyroid capsule invasion,lymph node dissection,parathyroid MIS resection,tumor diameter>4cm,no nano carbon tracer and open operation were the risk factors of parathyroid dysfunction after thyroidectomy(OR=3.963,3.658,3.281,3.357,3.943,4.187,P<0.05).Conclusion Patients with hypoparathyroidism after thyroidectomy have a high probability of hypoparathyroidism.The risk factors of hypoparathyroidism include thyroid capsule invasion,lymph node dissection,parathyroid MIS resection,tumor diameter>4cm,no application of nano carbon tracer and open surgery.According to this,clinical patients can be given targeted treatment and intervention measures after thyroidectomy,to reduce the risk of hypoparathyroidism.