甲状腺全切除术与非甲状腺全切除术对甲状腺癌患者喉返神经损伤及术后低钙血症发生情况的影响  

Effects of Total Thyroidectomy and Non-total Thyroidectomy on Recurrent Laryngeal Nerve Injury and Postoperative Hypocalcemia in Patients with Thyroid Cancer

作　　者：浦宸辰 PU Chenchen(Department of Thoracic and Breast Surgery,Taicang First People's Hospital,Taicang,Jiangsu Province,215400 China)

机构地区：[1]太仓市第一人民医院甲乳外科,江苏太仓215400

出　　处：《中外医疗》2022年第2期34-37,共4页China & Foreign Medical Treatment

摘　　要：目的探究甲状腺癌患者应用不同手术方式(甲状腺全切除术、非甲状腺全切除术)对于喉返神经损伤及术后低钙血症的影响。方法回顾性选择医院2016年1月—2020年12月期间接诊的210例甲状腺癌患者,根据随机数表法进行分组,对照组(105例)给予甲状腺全切除术治疗,观察组(105例)给予非甲状腺全切除术(包括非显露喉返神经甲状腺侧叶次全切除术、非显露喉返神经甲状腺全切除术)治疗,对比两组甲状腺癌患者的喉返神经损伤及术后低钙血症发生情况。结果观察组喉返神经损伤发生率(5.71%)低于对照组发生率(17.14%),差异有统计学意义(χ^(2)=6.774,P=0.009)。观察组低钙血症发生率为20.95%,对照组低钙血症发生率为37.14%,观察组低钙血症发生率低于对照组,差异有统计学意义(χ^(2)=6.677,P=0.009)。观察组术后1 d血钙水平(2.09±0.13)mmol/L、术后3 d血钙水平(2.06±0.11)mmol/L、术后7 d血钙水平(2.11±0.12)mmol/L均高于对照组(2.01±0.11)、(2.00±0.12)、(2.05±0.14)mmol/L,差异有统计学意义(t=4.813、3.776、3.334,P<0.05)。观察组术后1 d、术后3 d、术后7 d的甲状旁腺素水平分别为(14.36±1.89)、(19.35±2.78)、(27.63±3.55)mmol/L均高于对照组(13.11±0.95)、(17.36±3.11)、(24.04±1.52)mmol/L,差异有统计学意义(t=6.055、4.888、9.525,P<0.05)。结论甲状腺癌患者采用甲状腺全切除术会增加喉返神经损伤及术后低钙血症发生率。Objective To explore the effects of different surgical methods(total thyroidectomy,non-total thyroidectomy)on recurrent laryngeal nerve injury and postoperative hypocalcemia in patients with thyroid cancer.Methods The 210 patients with thyroid cancer admitted to the hospital from January 2016 to December 2020 were selected and grouped according to the random number table method.The control group(105 cases)were treated with total thyroidectomy.The observation group(105 cases)were treated with non-total thyroidectomy(including non-exposed recurrent laryngeal nerve subtotal thyroidectomy and non-exposed recurrent laryngeal nerve thyroidectomy).The recurrent laryngeal nerve injury and the occurrence of postoperative hypocalcemia in the two groups of thyroid cancer patients were compared.Results The incidence of recurrent laryngeal nerve injury in the observation group(5.71%)was lower than that in the control group(17.14%),and the difference was statistically significant(χ^(2)=6.774,P=0.009).The incidence of hypocalcemia in the observation group was 20.95%,and the incidence of hypocalcemia in the control group was 37.14%.The incidence of hypocalcemia in the observation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=6.677,P=0.009).In the observation group,the blood calcium level(2.09±0.13)mmol/L at 1 d after operation,the blood calcium level at 3 d after operation(2.06±0.11)mmol/L,and the blood calcium level at 7 d after operation(2.11±0.12)mmol/L were all higher than the control group(2.01±0.11)mmol/L,(2.00±0.12)mmol/L,(2.05±0.14)mmol/L,and the difference was statistically significant(t=4.813,3.776,3.334,P<0.05).The levels of parathyroid hormone(14.36±1.89)mmol/L,(19.35±2.78)mmol/L,and(27.63±3.55)mmol/L in the observation group at 1 d,3 d and 7 d after surgery were all higher than the control group(13.11±0.95)mmol/L,(17.36±3.11)mmol/L,(24.04±1.52)mmol/L,and the difference was statistically significant(t=6.055,4.888,9.525,P<0.05).Conclusion Total thyr

关 键 词：甲状腺癌 甲状腺全切除术 非甲状腺全切除术 喉返神经损伤 低钙血症 血钙水平 

分 类 号：R653[医药卫生—外科学]