腔镜下甲状腺切除术联合甲状旁腺移植术对甲状旁腺功能的影响  

Effect of endoscopic thyroidectomy combined with parathyroid transplantation on parathyroid function

作　　者：张琪 屈坤鹏 成晓舟 张宇鹏 王小虎[1] 曹维嘉 ZHANG Qi;QU Kunpeng;CHENG Xiaozhou;ZHANG Yupeng;WANG Xiaohu;CAO Weijia(The First Clinical Medical College,Gansu University of Chinese Medicine,Department of Hernia and Abdominal Wall Surgery,Gan-su Provincial People′s Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃省人民医院疝和腹壁外科,兰州730000

出　　处：《实用医学杂志》2021年第19期2492-2496,共5页The Journal of Practical Medicine

基　　金：吴阶平医学基金会临床科研专项资助基金(编号:320.6750.16216)。

摘　　要：目的评价腔镜下甲状腺切除术联合甲状旁腺移植术对患者甲状旁腺功能恢复的影响。方法选取2018年1月至2020年12月甘肃省人民医院普外科收治的72例甲状腺结节手术患者,监测手术前后移植侧、非移植侧血清甲状旁腺激素(parathyroid hormone,PTH)及体循环血清钙离子浓度,通过配对样本t检验,对比术后移植侧、非移植侧两组各时间点血清PTH浓度及手术前后体循环血清Ca^(2+)浓度,以此判断移植甲状旁腺存活及功能恢复情况。结果术后各监测时间点,移植侧与非移植侧血清PTH均呈上升趋势,移植侧血清PTH均不同程度高于非移植侧。术后第1天移植侧与非移植侧血清PTH比较,差异无统计学意义(P>0.05),随着康复时间延长,术后1周、1、2、3、6个月两组间血清PTH比较,差异有统计学意义(P<0.05)。术后第1天、1周、1、2个月体循环血清Ca^(2+)较术前均有所下降,但随着时间延长,Ca^(2+)逐步升高,至术后3个月,基本恢复至术前水平。术后第1天、1周、1、2个月体循环血清Ca^(2+)与术前比较,差异有统计学意义(P>0.05),而术后3、6个月体循环血清Ca^(2+)与术前比较,差异无统计学意义(P>0.05)。结论腔镜下甲状腺切除术联合甲状旁腺移植术可明显降低患者术后甲状旁腺功能减退发生率,有效改善患者术后PTH水平,提高血清Ca^(2+)浓度。ObjectiveTo evaluate the effect of endoscopic thyroidectomy combined with parathyroid transplantation on recovery of parathyroid function.Methods cal treatment from January 2018 to December 2020 in our hospital were selected.The baseline and postoperative serum parathyroid hormone(PTH)in the transplanted and non-transplanted sides and serum Ca^(2+)level in systemic circulation were detected.The postoperative serum PTH concentration in the transplanted and non-transplanted sides at different time points and the preoperative and postoperative serum Ca^(2+)concentrations were compared by paired sample t-test to judge the survival status and functional recovery of the transplanted parathyroid glands.Results higher at different degrees in the transplanted side than in the non-transplanted side.There was no significant difference in serum PTH level between the transplanted and non-transplanted side on postoperative day 1(P>0.05).With the prolonged recovery duration,there was a statistically significant difference in serum PTH between the transplanted and the non-transplanted side in postoperative week 1,months 1 to 3,and month 6(P<0.05).Serum Ca^(2+)in the systemic circulation decreased on postoperative day 1 and in week 1 and months 1 to 2.As time went by,Ca^(2+)gradually increased and basically recovered to the preoperative level by month 3.As compared with preoperative serum Ca^(2+)on postoperative day 1 and in week 1 and months 1 to 2,the difference was statistically significant(P>0.05).However,there were no statistically significant differences in serum Ca^(2+)in systemic circulation between the baseline and postoperative level in months 3 and 6(P>0.05).ConclusionsEndoscopic thyroidectomy combined with parathyroid transplantation evidently lowered the rate of hypoparathyroidism,effectively improved PTH,and increased Ca^(2+)level following surgical treatment.

关 键 词：甲状旁腺移植 腔镜手术 甲状旁腺激素 甲状腺结节 血清钙离子 甲状旁腺解剖 

分 类 号：R653[医药卫生—外科学]