不同甲状腺癌根治术对甲状旁腺功能损伤的影响  

The influence on the function of parathyroid after different thyroid cancer radical operation

作　　者：陈征[1] 董汉华[1] 叶真[2] 

机构地区：[1]郑州大学附属郑州中心医院甲状腺头颈外科,郑州450007 [2]河南省肿瘤医院头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第15期1232-1235,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:通过检测术前及术后甲状旁腺素(PTH)及血清钙Ca2+值的变化,评价不同甲状腺全切术后甲状旁腺功能的影响及处理措施。方法:回顾性分析首次进行甲状腺全切手术的患者172例,分为单纯甲状腺全切组(A组)、甲状腺全切+单侧中央区淋巴结清扫组(B组)、甲状腺全切+双侧中央区淋巴结清扫组(C组),检测术前及术后24h内、第3天的PTH及Ca2+值并进行比较分析。结果:3组术后PTH及Ca2+值均较术前下降,B组和C组术后与术前比较,差异均有统计学意义(P<0.05),其中A组与C组甲状旁腺功能减退的发生率差异有统计学意义(P<0.05)。结论:随着手术范围的扩大,出现甲状旁腺功能减退及低血钙的可能性增大,因此在甲状腺癌根治术尤其是中央区淋巴结清扫中甲状旁腺的识别与保留显得至关重要,应尽可能减少永久性甲状旁腺功能减退的发生。Objective：The aim of this study is to detect the changes of parathyroid hormone and serum calcium levels before and after operation, and evaluate the effect and treatment of parathyroid function after total thyroid- ectomy. Method：One hundred and seventy-two cases of initial total thyroidectomy were analysed retrospectively, who were divided into simple total thyroidectomy group（A）, total thyroidectomy with unilateral central lymph node dissection group（B） ,and total thyroidectomy with lateral central lymph node dissection group？. We analyse the preoperative and postoperative serum calcium and parathyroid hormone. Result：In three groups, the serum concen- trations of the parathyroid hormone and calcium decreased after operation. The difference was statistically signifi- cant between in B group and C group（P〈0.05）;The hypoparathyroidism had statistical significance between A group and C group（P〈0.05）. Conclusion：The possibility of hypoparathyroidism and hypocalcemia was increasing with the expansion of the range of operation. Therefore, retain vital recognition of parathyroid gland was very im- portant in the resection of thyroid cancer especially central lymph node dissection. We should reduce the incidence of permanent hypoparathyroidism As far as possible.

关 键 词：甲状旁腺 甲状旁腺功能减退 甲状腺肿瘤 

分 类 号：R736.1[医药卫生—肿瘤]