碳酸钙D3联合骨化三醇在甲状腺癌全切术后低钙血症预防中的应用效果

Effect of calcium carbonate D3 combined with calcitriol on the prevention of hypocalcemia after total thyroidectomy

目的探讨碳酸钙D3联合骨化三醇在甲状腺癌全切术后低钙血症预防中的应用效果。方法选取2019年9月至2022年5月期间连云港市第一人民医院收治的106例行甲状腺癌全切术的患者,随机数表法分为2组,各53例。对照组术前1周开始服用碳酸钙D3,并持续至术后2周,观察组在对照组的基础上同时服用骨化三醇。分别于不同时间对患者血清钙及血清PTH水平进行检测,评估患者低钙血症发生情况,观察药物不良反应及术后并发症发生情况。结果观察组术后1周及术后3个月血清钙水平均高于对照组;观察组术后1周及术后3个月PTH水平均高于对照组;2组术后1周低血钙、症状性低血钙症发生率比较,差异无统计学意义(P>0.05),观察组低血钙症发生率低于对照组(P<0.05);观察组、对照组的并发症发生率差异无统计学意义(P>0.05);观察组、对照组的不良反应率,差异无统计学意义(P>0.05)。结论碳酸钙D3联合骨化三醇能够改善甲状腺癌全切术后血清钙及血清PTH水平,降低术后低钙血症发生率,有效预防术后低钙血症的发生,未出现明显药物不良反应,且未增加术后并发症的发生率。

Objective To investigate the effect of calcium carbonate D3 combined with calcitriol on the prevention of hypocalcemia after total resection of thyroid cancer.Methods From September 2019 to May 2022,106 patients treated with total thyroidectomy in Lianyungang First People's Hospital were divided into 2 groups with 53 cases in each group randomly.The patients in control group received calcium carbonate D3 one week before surgery and continued to two weeks after surgery.The patients in observation group received calcitriol on the basis of the control group.Serum calcium and serum PTH levels were detected at different points of time.The occurrences of hypocalcemia,adverse drug reactions and postoperative complications were observed.Results The serum calcium level of the observation group was higher than that of the control group at one week and three months after operation.The level of PTH in the observation group was higher than that in the control group at one week and three months after operation.There was no significant difference in the incidence of hypocalcemia and symptomatic hypocalcemia at one week after operation between two groups(P>0.05).The incidence of hypocalcemia in observation group was lower than that in control group(P<0.05).There was no significant difference on complication rates and adverse reaction rates between the two groups(P>0.05).Conclusions Calcium carbonate D3 combined with calcitriol improves serum calcium and serum PTH levels after total resection of thyroid cancer,reduces the incidence of postoperative hypocalcemia,and prevents the occurrence of postoperative hypocalcemia effectively,without the increasing of postoperative complications.