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作 者:王建宏[1] 饶远生[1] 刘海鹰[1] 阎晓娟 房居高[1] WANG Jianhong;RAO Yuansheng;LIU Haiying(Beijing Anzhen Hospital,Affiliated to Capital Medical University,Beijing,100029)
出 处:《实用癌症杂志》2018年第7期1190-1193,共4页The Practical Journal of Cancer
基 金:首都临床特色应用研究项目(编号:D1011007889010598)
摘 要:目的探讨甲状腺全切术治疗分化型甲状腺癌对甲状旁腺激素及血钙变化的影响。方法选择分化型甲状腺癌患者142例作为研究对象,根据入院的病情分为观察组与对照组各71例,观察组(双侧病变)给予甲状腺全切术,对照组(单侧病变)行保留对侧部分腺体近全切除术,记录甲状旁腺激素(PTH)及血钙变化。结果所有患者都顺利完成手术,两组的术后住院时间、手术时间、术中出血量等对比差异无统计学意义(P>0.05)。两组术后第1 d、术后第3 d的血钙与PTH值都低于术前,观察组术后第1 d、术后第3 d的血钙与PTH值低于对照组(P<0.05),且低钙血症与甲状旁腺功能减退的发生率也高于对照组(P<0.05)。观察组术后喉返神经损伤、皮下气肿、皮下积液、淋巴漏并发症发生率为15.5%,对照组为12.7%,两组差异无统计学意义(P>0.05)。结论相对于次全切术,甲状腺全切术能有效根治双侧甲状腺分化型癌病变,且不会影响患者的康复与术后并发症的发生,且低钙、甲状旁腺功能减退可以恢复。Objective To investigate the parathyroid hormone and serum calcium effects of total thyroidectomy in patients with differentiated thyroid carcinoma. Methods 142 patients of differentiated thyroid carcinoma were selected as the research object,all the patients were divided into the observation group and the control group,with 71 patients in each group the observation group (bilateral lesions) received total thyroidectomy,and the control group (unilateral lesion) receiced retained partial resection of the contralateral part of the gland,recorded parathyroid hormone (PTH) and the changes of serum calcium. Results All the patients completed the operation successfully.There were no significant difference compared between the 2 groups in terms of postoperative hospital stay,operation time and the amount of bleeding during operation ( P 〉0.05).The postoperative 1 d,3 d serum calcium and PTH 3 in the two groups were lower than those preoperative,the postoperative 1d,3d serum calcium and PTH 3 in the observation group were higher than those of the control group ( P 〈0.05).The postoperative 1 d,3 d rates of hypocalcemia and hypoparathyroidism in the observation group were lower than those of the control group( P 〈0.05).the postoperative 1months of recurrent laryngeal nerve injury,subcutaneous emphysema,subcutaneous hydrops,lymph leakage was 15.5% in the observation group,and 12.7% in the control group,there was no significant difference between the observation group and the control group ( P 〉0.05). Conclusion Compares with subtotal resection,total thyroidectomy for differentiated thyroid carcinoma can effectively radically treat the bilateral differentiated thyroid carcinoma,and has no effects on rehabilitation and postoperative complications,and the low calcium and hypoparathyroidism can be restored.
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