甲状腺二次手术中甲状旁腺损伤的影响因素及功能保护措施分析  

Influencing Factors and Functional Protective Measures of Parathyroid Gland Injury in Secondary Thyroid Surgery

作　　者：白春林 胡志强[2] 肖莉 王韧 何涛 张天佑 BAI Chunlin;HU Zhiqiang;XIAO Li;WANG Ren;HE Tao;ZHANG Tianyou(The First Department of Surgery,Ningxia Corps Hospital of the Armed Police,Yinchuan,Ningxia Hui Autonomous Region,750001 China;The Third Department of Surgery,Cancer Hospital of Ningxia Medical University,Yinchuan,Ningxia Hui Autonomous Region,750001 China)

机构地区：[1]武警宁夏总队医院外一科,宁夏银川750001 [2]宁夏医科大学肿瘤医院外三科,宁夏银川750001

出　　处：《中外医疗》2022年第30期1-4,共4页China & Foreign Medical Treatment

摘　　要：目的 对甲状腺二次手术中甲状旁腺损伤的危险因素和功能保护措施进行探讨。方法 回顾性选取2016年4月—2021年6月武警宁夏总队医院收治的62例甲状腺二次手术患者作为研究对象,根据项目实施要求,以甲状旁腺有无损伤分为对照组(无损伤)和研究组(损伤),每组31例。分析甲状腺二次手术中甲状旁腺损伤的危险因素。结果 两组患者的手术入路、甲状腺手术方式及是否Ⅵ区淋巴清扫比较,差异有统计学意义(χ^(2)=6.798、16.672、4.309,P<0.05)。Logistic回归分析结果显示,手术入路原切口入路、全切的手术方式、Ⅵ区淋巴清扫是甲状旁腺损伤的危险因素(OR=5.706、12.398、2.265,P<0.05)。结论 甲状腺再次手术中甲状旁腺损伤的危险因素主要包括原切口入路、全切除、Ⅵ区淋巴结清扫,因此,尽量避免甲状腺再次手术,同时医师应该对手术各项注意点全方位正确掌握,根据患者的实际情况,选择合适的手术方式,并规范化操作,尽可能避免损伤。Objective To investigate the risk factors and functional protection measures of parathyroid gland injury during secondary thyroid surgery. Methods Retrospectire selection 62 patients with secondary thyroid surgery who were admitted to the Ningxia Corps Hospital of the Armed Police from April 2016 to June 2021 as the research object.According to the requirements of project implementation, the patients were divided into control group(no injury) and study group(injury) by with or without parathyroid injury, with 31 cases in each group. Analyzed of risk factors for parathyroid injury in secondary thyroid surgery. Results Comparison of surgical approach, thyroid surgery method and regional lymphatic dissection were made between the two groups, the difference was statistically significant(χ^(2)=6.798,16.672, 4.309, P<0.05). The results of Logistic regression analysis showed that the original incision approach and the surgical method of total resection and Ⅵ lymph node dissection were risk factors for parathyroid injury(OR=5.706,12.398, 2.265, P<0.05). Conclusion The risk factors of parathyroid injury during thyroid reoperation mainly include the original incision approach, total resection, and lymph node dissection at level Ⅵ. Therefore, reoperation of the thyroid gland should be avoided as much as possible. At the same time, physicians should have a full and correct grasp of the various points of attention in the operation, select the appropriate surgical method according to the actual situation of the patient, and standardize the operation to avoid injury as much as possible.

关 键 词：甲状腺二次手术 甲状旁腺损伤 危险因素 功能保护措施 

分 类 号：R5[医药卫生—内科学]