甲状腺手术中甲状旁腺损伤的预防和术后低钙血症的治疗  

Prevention and coping research of patients in thyroid surgery to parathyroid damage and hypocalcemia

作　　者：李文强[1] 吕娟[1] 王凯辉[1] 

机构地区：[1]广东东莞市樟木头人民医院外二科,东莞523633

出　　处：《河南外科学杂志》2014年第2期2-4,共3页Henan Journal of Surgery

摘　　要：目的探讨甲状腺术中甲状旁腺损伤的预防和术后低钙血症治疗。方法选择134例接受甲状腺手术的患者作为研究对象,探讨不同手术方式术后甲状旁腺功能低下的发生情况、治疗效果及预后。结果双侧甲状腺叶全切除及中央区淋巴清扫术患者甲状旁腺功能低下症状的总发生率显著高于实施双侧腺叶次全切除术、单侧腺叶次全切除及对侧腺叶部分切除术及单侧或双侧甲状腺叶大部分切除术的患者,差异均有统计学意义(P<0.05)。实施甲状腺手术后1 d,患者血清Ca2+水平均有所下降,除单侧或双侧甲状腺叶大部分切除术外,与术前相比,差异均有统计学意义(P<0.05)。术后3 d血清Ca2+水平开始回升,术后5 d时,仅有一侧腺叶全切除及对侧腺叶部分切除术以及双侧甲状腺叶全切除及中央区淋巴清扫术两种术式较术前的血清Ca2+水平差异有统计学意义(P<0.05)。全部患者中共有9例发生低钙血症。结论为患者实施甲状腺手术时,应避免伤及甲状旁腺及其血供,可减少低钙血症的发生。Objective To study prevention and coping research of patients in thyroid surgery to parathyroid damage and hypocalcemia. Methods sFrom July 2012 to July 2013,134 cases of patients with thyroid surgery in our hospital implemented as an object of study,the surgery based on the patients＇ condition respectively,the comparison of different surgical patients with parathyroid dysfunction symptoms and the efficacy of different treatment,and prognosis. Results Lymphatic clear symptoms of hypoparathyroidism in patients undergoing bilateral total incidence of thyroid resection and central regions was significantly higher than the implementation of bilateral gland subtotal resection,unilateral gland and on the subtotal patients with partial side lobe resection and most of unilateral or bilateral thyroid resection,the differences were statistically significant（ P 〈 0. 05）. 1 d after the implementation of thyroid surgery,serum Ca2 ＋levels were decreased,except for most of unilateral or bilateral thyroid resection,as compared with the preoperative differences were statistically significant（ P 〈 0. 05）. 3d postoperative serum Ca2 ＋levels began to rise 5d after surgery,only one side of the lobe resection and partial contralateral lobe resection and bilateral thyroid resection and lymph node dissection central district representing two surgical technique differences in serum Ca2 ＋levels before was statistically significant（ P 〈 0. 05）. All patients with a total of 9 cases had hypocalcemia. Conclusion The implementation of thyroid surgery patients should avoid harming parathyroid their blood supply,which can reduce the incidence of complications,such as hypocalcemia,worthy of recommendation.

关 键 词：甲状腺手术 甲状旁腺 损伤 低钙血症 预防应对 

分 类 号：R653[医药卫生—外科学]