甲状腺癌术后引起甲状旁腺功能减退的早期症状分析  

Analysis of Early Symptoms of Hypoparathyroidism after Thyroid Carcinoma Surgery

作　　者：彭晓智[1] 黎宗保[1] 裴翔[1] 

机构地区：[1]海南省农垦三亚医院,572000

出　　处：《实用癌症杂志》2016年第9期1537-1539,共3页The Practical Journal of Cancer

摘　　要：目的探讨甲状腺癌术后甲状旁腺激素(PTH)和血钙的变化,评估术后甲状旁腺功能减退和血钙降低的情况和处理措施。方法 93例甲状腺癌患者进行手术切除治疗,根据颈淋巴清扫程度分为A、B、C 3组,检测比较3组患者术前和术后第1、3、5天的血液中PTH和钙离子水平。结果术后各组患者的PTH和血钙水平较术前均显著下降(P<0.05),术后第1天时出现最低值;各组水平间比较为仅甲状腺全切>单侧颈淋巴清扫>双侧颈淋巴清扫;。术后各组患者均有低PTH、低钙症和低血钙症发生,各组比较,双侧颈淋巴清扫>单侧颈淋巴清扫>单纯甲状腺切除(P<0.05)。结论甲状腺癌术后甲状旁腺功能减退,且程度与手术范围呈正相关;术后第1天可选为检测术后甲状旁腺功能和血钙水平的时间点。Objective To study the changes of parathyroid hormone （PTH） and serum calcium after thyroid carcinoma surgery,and evaluate the condition and treatment of hypoparathyroidism and hypocalcemia. Methods 93 patients treated with thyroid carcinoma resection were divided into A B C 3 groups according to the scope of lymph node dissection. Serum levels of PTH and calcium preoperative and postoperative day 1,3,5 were detected and compared. Results Serum level of PTH and calci- um postoperative and preoperative significantly decreased （ P 〈 0.05 ）, and the lowest appeared at postoperative day 1, and thy- roidectomy 〉 unilateral thyroid compartment lymph node dissection （CLND） 〉 bilateral CLND. Postoperative complication e- merged in all groups, such as low PTH,low calcium and low blood calcium. The complication morbidity rate was bilateral CLND 〉 unilateral CLND 〉 pure thyroid resection （ P 〈 0.05 ）. Conclusion Parathyroid function declined after thyroid carcinoma operation, and the degree of hypoparathyroidism is positively correlated with the scope of operation. Postoperative parathyroid func- tion and blood calcium level should be detected first day after surgery.

关 键 词：甲状腺癌 甲状旁腺 功能减退 早期症状 

分 类 号：R736.1[医药卫生—肿瘤]