甲状腺术后甲状旁腺功能减退的风险因素

Risk Factors for Hypoparathyroidism after Thyroidectomy

目的探讨甲状腺切除术后甲状旁腺功能减退(post surgical hypoparathyroidism,HypoPT)的风险因素分析及同时存在风险因素的数量与HypoPT发生率之间的关系,从而指导临床治疗。方法回顾性分析2021年7月至2022年3月在云南省肿瘤医院行甲状腺切术后并具备完整病人资料266例,采用单因素分析与多因素Logistic回归分析HypoPT的风险因素分析及同时存在风险因素的数量与HypoPT发生率之间的关系。结果(1)单因素分析结果:年龄、体重指数(body mass Index,BMI)、高血压、代谢综合征(metabolicsyndrome,MS)、肿块性质、T分期、VI区淋巴结清扫(central lymph node dissection,CLND)、淋巴结是否转移、周围侵犯、腺叶切除方式(单侧全切、双侧全切)有统计学意义(P<0.05);(2)Logistic多因素分析结果:MS、CLND、肿块性质、淋巴结是否结转移是HypoPT发生率的独立危险因素(P<0.05);(3)调整年龄和其他临床因素后,存在风险因素的数量与HypoPT发生率之间的关系之间存在正相关。结论(1)年龄、BMI、高血压、MS、肿块性质、T分期、CLND、淋巴结是否转移、周围侵犯、腺叶切除方式会影响HypoPT的发生率;(2)MS、CLND、肿块性质、淋巴结转移是HypoPT的独立危险因素;(3)同时存在风险因素的数量与HypoPT发生率之间存在正相关。

Objective To explore the risk factors of hypoparathyroidism(HypoPT)after thyroidec-tomy and analyze the relationship between the number of coexisting risk factors and the incidence of HypoPT,so as to guide the clinical treatment.Methods A total of 266 patients with the complete data after the thyroidectomy in Yunnan Cancer Hospital from July 2021 to March 2022 were retrospectively analyzed.Univariate analysis and multivariate Logistic regression were used to analyze the risk factors of HypoPT and the relationship between the number of co-existing risk factors and the incidence of HypoPT.Results(1)Univariate analysis results:There were statistically significant differences in age,body mass index(BMI),hypertension,metabolic syndrome(MS),mass nature,T stage,central lymph node dissection(CLND),lymph node metastasis,surrounding invasion,gland lobectomy method(unilateral total resection,bilateral total resection)(P<0.05);(2)Logistic multivariate analysis results:MS,CLND,tumor nature,Lymph node metastasis were the independent risk factors for the incidence of HypoPT(P<0.05);(3)After adjusting for age and other clinical factors,there was a positive correlation between the number of risk factors and the incidence of HypoPT.Conclusion(1)Age,BMI,hypertension,MS,mass nature,T stage,CLND,lymph node metastasis,peripheral invasion,and gland lobectomy method will affect the incidence of Hypo PT;(2)MS,CLND,mass nature,lymph node metastasis are independent risk factor for Hypo PT;(3)There is a positive correlation between the number of risk factor and the incidence of HypoPT.