甲状腺手术并发甲状旁腺损伤的研究  

Research of hypoparathyroidism after thyroidectomy

作　　者：刘星伟[1] 殷放[1] 贾英斌[1] 曾庆安[1] 

机构地区：[1]中山大学附属第五医院普外科,广东省珠海市519000

出　　处：《中国医药》2010年第12期1147-1148,共2页China Medicine

摘　　要：目的 探讨甲状腺手术中引起甲状旁腺损伤的原因及防治对策.方法 我院132例甲状腺疾病患者行双侧甲状腺腺叶全切或近全切术,观察术后甲状旁腺功能减退的发生情况.根据有无结扎甲状腺下动脉将132例患者分为2组,结扎组19例,未结扎组113例,比较2组治疗前后血钙浓度.结果 术后18例出现暂时性甲状旁腺功能低下,1例出现永久性甲状旁腺功能低下,结扎组16例（84.2%）甲状旁腺功能低下,未结扎组2例（1.8%）甲状腺功能低下.术后7 d结扎组患者血钙浓度为（1.79±0.23）mmol/L,低于未结扎组（2.13±0.16）mmol/L（P＜0.05）.结论 甲状腺手术后并发甲状旁腺功能低下主要与甲状腺下动脉主干损伤有关,术中精细解剖,保护甲状旁腺及其血供,可避免术后并发甲状旁腺功能低下.Objective To investigate the reason and treatment for hypoparathyroidism after thyroidectomy.Methods One hundred and thirty-two patients with thyroid neoplasms underwent total thyroidectomy or subtotal thyroidectomy. Parathyroid function of all these patents was observed after operation. Results Total 18 patients had transient hypoparathyroidism and one patient had eternal hypoparathyroidism after thyroidectomy, among them the trunks of inferior thyroid arteries were definitely ligated in 16.One hundred and thirteen patients had normal parathyroid function. Conclusions Hypoparathyroidism after thyroidectomy was caused mainly because the trunk of inferior thyroid arteries was ligated. During operation parathyroid glands and their supply arteries should be exposed and preserved, in order to prevent hypoparathyroidism after surgery.

关 键 词：甲状腺肿瘤 甲状旁腺功能减退症 甲状腺切除术 

分 类 号：R653[医药卫生—外科学]