即刻甲状旁腺自体移植术在全甲状腺切除术中的应用  

Application of immediate parathyroid autograft in total thyroidectomy

作　　者：王玲[1] 李会政[1] 崔玲[1] WANG Ling;LI Hui-zheng;CUI Ling(Department of Otorhinolaryngology Head and Neck Surgery,Dalian Friendship Hospital,Liaoning Province,Dalian116001,China)

机构地区：[1]大连市友谊医院耳鼻咽喉头颈外科,辽宁大连116001

出　　处：《中国当代医药》2020年第7期95-97,101,共4页China Modern Medicine

摘　　要：目的探讨即刻甲状旁腺自体移植术在全甲状腺切除术中的应用。方法选取2017年7月~2019年4月我院收治的88例全甲状腺切除患者作为研究对象,按手术方法的不同分为对照组(56例)和观察组(32例)。对照组采用精细化被膜解剖的方法,观察组采用精细化被膜解剖+即刻甲状旁腺自体移植术。比较两组术前及术后不同时段的甲状旁腺素(PTH)、血钙(Ca)水平及两组甲状旁腺的损伤情况。结果两组术前的PTH及血Ca水平比较,差异无统计学意义(P>0.05);两组术后1、2、3 d,术后1周、1个月的PTH及血Ca水平低于术前,观察组术后1 d和术后1个月的PTH水平高于对照组,观察组术后1、2、3 d,术后1周、1个月的血Ca水平高于对照组,差异均有统计学意义(P<0.05)。观察组的暂时性甲状旁腺损伤发生率低于对照组,差异有统计学意义(P<0.05);两组的永久性甲状旁腺损伤发生率比较,差异无统计学意义(P>0.05)。结论即刻甲状旁腺自体移植术应用于全甲状腺切除术中能稳定PTH及血Ca水平,降低暂时性甲状旁腺损伤发生率。Objective To investigate the application of immediate parathyroid autograft in total thyroidectomy.Methods Eighty-eight patients with total thyroidectomy admitted in our hospital from July 2017 to April 2019 were selected as the research objects,they were divided into the control group(56 cases)and the observation group(32 cases)according to different surgical methods.The control group used a fine capsule anatomy,the observation group used a fine capsule anatomy+immediate parathyroid autograft.The levels of parathyroid hormone(PTH),blood calcium(Ca)before and after different periods of operation and the damage of parathyroid gland were compared between the two groups.Results There was no significant difference in PTH and blood Ca levels between the two groups before surgery(P>0.05).At 1,2,and 3 days,1 week and 1 month after surgery,the PTH and blood Ca levels in the two groups were lower than before surgery,the PTH level in the observation group at 1 day and 1 month after surgery were higher than those in the control group,the levels of blood Ca in the observation group at 1,2,and 3 days,1 week and 1 month after surgery were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of temporary parathyroid injury in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of permanent parathyroid injury between the two groups(P>0.05).Conclusion Immediate parathyroid autograft applied to total thyroidectomy can stabilize PTH and blood Ca levels and reduce the incidence of temporary parathyroid injury.

关 键 词：全甲状腺切除术 精细化被膜解剖 甲状旁腺自体移植术 甲状旁腺功能减退症 

分 类 号：R322.52[医药卫生—人体解剖和组织胚胎学]