甲状腺癌术后血钙及血清甲状旁腺激素检测的临床意义  

Clinical significance of detection of thyroid carcinoma postoperative serum calcium and serum parathyroid hormone

作　　者：周晓莉[1] 饶一武[2] 朱梅[1] 

机构地区：[1]湖北医药学院附属东风医院核医学科,湖北十堰442008 [2]湖北医药学院附属东风医院内科,湖北十堰442008

出　　处：《热带医学杂志》2015年第2期237-240,共4页Journal of Tropical Medicine

摘　　要：目的探讨采用不同手术方式切除甲状腺的甲状腺癌患者手术前后血钙及血清甲状旁腺激素（PTH）水平的变化及临床意义。方法回顾性分析2012年1月至2013年6月在湖北医学院附属东风医院住院的行不同手术方式切除甲状腺的甲状腺癌患者,应用化学发光方法,动态检测手术前后血钙及血PTH水平的变化。结果 71例患者中32例出现暂时性甲状旁腺功能减退,发生率45.1%;38例发生低钙血症,发生率53.5%;7例发生症状性低钙血症,发生率23.9%。再次手术患者发生甲状旁腺功能减退及低钙血症的机率最高,甲状腺全切、次全切除患者甲状旁腺功能减退及低钙血症发生率最低。甲状腺术后血PTH值在1 h-1 d降至最低;血钙值在1~2 d降至最低;相关性分析显示血PTH值与血钙值呈正相关关系。结论甲状腺癌患者随着甲状腺手术范围的扩大,暂时性甲状旁腺功能减退及低钙血症的发生率增高,甲状腺癌患者应常规于术中1 h或术后1 d检测血PTH值,以预测低钙血症的发生。Objective To study the different operation mode of the thyroid gland excision of thyroid cancer patients to clinical significance of changes of serum calcium and serum parathyroid hormone level before and after operation. Methods Retrospective analysis of different operation mode of thyroid resection in thyroid cancer patients in Dongfeng hospital was performed. Chemical luminescence method was used to detect the changes of serum calcium and parathyroid hormone levels before and after dynamic monitoring operation. Results In 71 patients,32 patients had hypoparathyroidism, with the incidence of 45.1%;38 cases with hypocalcemia, with the incidence rate of 53.3%;symptomatic hypocalcemia occurred in 7 cases, with the incidence of 23.9%0 Hypoparathyroidism patients with repeated operation had the highest incidence of hypocalcemia; for those received total thyroidectomy, the parathyroid function in patients hadsubtotal decline and the lowest incidence of hypoealcemia. Thyroid postoperative blood ~ and serum calcium values in the 1 h-1 d were dropped to a minimum. Correlation analysis showed that serum PTH value was positively correlated with serum calcium. Conclusion With the expansion of the scope of operation in the thyroid cancer patients, there were an increase in the risk of temporary hypoparathyroidism and the incidence of hypocalcemia. Thyroid cancer patients after operation should routinely detect the serum PTH value, in order to predict the occurrence of hypocaleemia.

关 键 词：甲状腺癌 甲状腺切除术 血清甲状旁腺激素 低钙血症 甲状旁腺功能减退 

分 类 号：R736.1[医药卫生—肿瘤]