脉络舒通丸联合达肝素用于甲状腺全切术后甲状旁腺功能的恢复  

Mailuoshutong pill and dalteparin on recovery of parathyroid function after total thyroidectomy

作　　者：刘嘉琦 初军 于河山 张超[1] 孔琳娜 丁宇[1] LIU Jiaqi;CHU Jun;YU Heshan;ZHANG Chao;KONG Linna;DING Yu(Department of Breast and Thyroid Surgery,Zibo Central Hospital,Zibo Shandong 255000,China)

机构地区：[1]淄博市中心医院乳腺甲状腺外科,淄博山东255000

出　　处：《临床与病理杂志》2022年第12期3011-3016,共6页Journal of Clinical and Pathological Research

摘　　要：目的:探讨脉络舒通丸联合达肝素用于甲状腺全切术后出现甲状旁腺功能低下的治疗及安全性。方法:采用回顾性分析,收集2018年1月1日至2021年4月1日于淄博市中心医院乳腺甲状腺外科行甲状腺全切及中央区淋巴结清扫的1 145例甲状腺癌患者的临床资料。共有389例患者于术后出现甲状旁腺功能减低,其中305例患者(作为抗凝组)于术后第1天予补钙治疗及脉络舒通丸联合达肝素抗凝治疗,84例患者(作为对照组)术后仅予补钙治疗。分析两组患者永久性甲状旁腺功能低下发生率、甲状旁腺功能恢复至正常的时间、术后拔管时间及日均引流量。结果:1 145例患者术后甲状旁腺功能低下发生率为33.97%。抗凝组甲状旁腺永久性损伤率小于对照组(P<0.05)。两组患者术后拔管时间、日均引流量比较,差异均无统计学意义(P=0.10,P=0.80)。抗凝组术后甲状旁腺于术后第15、30、90、180天恢复速度均明显快于对照组(均P<0.05)。结论:给予甲状腺全切术后发生甲状旁腺功能低下患者补钙治疗及脉络舒通丸联合达肝素抗凝治疗,可以促进甲状旁腺功能的恢复,降低永久性功能损伤的发生率,术后使用安全可靠。Objective: To investigate the efficacy and safety of the treatment with Mailuoshutong pill and dalteparin on patients with hypoparathyroidism after total thyroidectomy. Methods: The clinical data of 1 145 patients with thyroid cancer after total thyroidectomy and lymph node dissection were collected and retrospective analyzed at Breast and Thyroid Surgery Department of Zibo Central Hospital from January 1, 2018 to April 1, 2021. There were 389 patients with hypoparathyroidism were involved, in which 305 patients(as an anticoagulation group) were treated with combination of Mailuoshutong pill and calcium supplement, and 84 patients(as a control group) were treated with calcium supplement. The incidence of hypoparathyroidism, recovery time, decannulation time, and average daily drainage volume between the 2 groups were analyzed. Results: The incidence of postoperative hypothyroidism in 1 145 patients was 33.97%. The rate of parathyroid injury in the anticoagulation group was lower than that in the control group(P<0.05). There was no significant difference in decannulation time(P=0.10) and average daily drainage volume(P=0.80) between the 2 groups. The recovery of the anticoagulation group was significantly beTher than the control group on the 15th, 30th, 90th, and 180th day after the operation(all P<0.05). Conclusion: Calcium supplement, Mailuoshutong pill, and dalteparin therapy for patients with hypoparathyroidism after total thyroidectomy can improve, the recovery of parathyroid function and reduce the incidence of permanent functional damage. It is safe and reliable for postoperative use.

关 键 词：甲状腺恶性肿瘤 甲状腺全切 甲状旁腺功能低下 抗凝治疗 补钙治疗 脉络舒通丸 达肝素 

分 类 号：R736.1[医药卫生—肿瘤]