不同术式对甲状腺手术后患者血钙变化的影响  

Effects of different surgery methods of thyroid on postoperative serum calcium changes

作　　者：王清野 

机构地区：[1]辽宁省辽阳市中心医院普外一科,辽宁辽阳111000

出　　处：《中国现代医生》2015年第3期35-37,共3页China Modern Doctor

摘　　要：目的：探讨不同术式对甲状腺手术前后患者血钙变化的影响。方法回顾性分析我院自2010年10月～2013年1月收治的行甲状腺手术患者84例，根据患者病情分别行甲状腺双侧大部切除31例，一侧叶全切＋峡部及对侧大部切除17例，单侧全切除26例，双侧全切除10例，比较四组术后患者血钙变化情况。结果甲状腺双侧大部切除、双侧全切除在术后1 d、2 d、4 d、6 d，血钙水平均显著低于同组术前血钙水平（P＜0.05）。一侧叶全切＋峡部及对侧大部切除组，在术后1 d、2 d、4 d，显著低于术前（P＜0.05）。单侧全切除术，在治疗1 d、2 d后，显著低于术前（P＜0.05）。84例患者中术后出现低血钙者共52例，以甲状腺双侧大部切除术及双侧全切除术为发生率最高，为80.6%和80.0%，一侧叶全切＋峡部及对侧大部切除及单侧全切除出现低血钙分别为41.2%和46.2%。而其中有症状者18例（34.6%），无症状者34例（65.4%）。结论甲状腺手术后低钙血症的发生与病理情况及手术方式有关。Objective To evaluate the effect of differ surgey of thyroid gland to the diversification post-hypocalcemia. Methods Retrospectively analyzed 84 cases with thyroid gland treated from October 2010 to January 2013, the 31 cases were bilater most excision,the 17 cases were single complete excision and opposite side, isthmus,the 26 cases were single complete excision,the 10 cases were bilater complete excision. The diversification post-hypocalcemia were com-pared. Results The level of 1 d, 2 d, 3 d hypocalcemia were significant lower in the bilater most excision and bilater complete excision（P〈0.05）. The level of 1 d, 2 d, 4 d hypocalcemia were significant lower in the single complete exci-sion and opposite side, isthmus （P〈0.05）. The level of 1 d, 2 d hypocalcemia were significant lower in the single complete excision（P〈0.05）. There were 52 cases of hypocalcemia in all cases. The most rate were 80.6% and 80.0% in the bi later most excision and bilater complete excision. The rate were 41.2% and 46.2% in the single complete excision and single complete excision and opposite side,isthmus. The symptom of patients were 18 cases （34.6%）and no symp tom were 34 cases （65.4%）. Conclusion The occurrence of hypocalcemia has been related to the pathology and surgical method.

关 键 词：甲状腺 不同手术方式 低钙血症 

分 类 号：R736.1[医药卫生—肿瘤]