甲状腺肿瘤小切口术后甲状旁腺损伤的影响因素临床研究  

Clinical Study on Influence Factors of Parathyroid Gland Injury after Small Incision Surgery for Thyroid Tumor

作　　者：叶建洋 YE Jianyang(Pinghe County Hospital,Pinghe 363700,China)

机构地区：[1]平和县医院,福建平和363700

出　　处：《中外医学研究》2023年第13期125-128,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨甲状腺肿瘤小切口术后甲状旁腺损伤的影响因素。方法:选取2020年3月—2021年12月平和县医院收治的120例甲状腺肿瘤小切口手术患者作为研究对象,根据术后第1天甲状旁腺激素(PTH)水平分为甲状旁腺功能减退组(简称减退组,PTH<15 pg/mL,n=42)和甲状旁腺功能正常组(简称正常组,PTH为15~65 pg/mL,n=78),分析所有患者资料,单因素和多因素logistic回归分析患者术后出现甲状旁腺损伤的主要危险因素。结果:两组年龄、病灶直径、气管食管沟淋巴结清扫、病理类型、术前PTH、未使用纳米碳示踪剂比较,差异均有统计学意义(P<0.05)。将单因素分析中差异有统计学意义的因素作为多因素logistic回归分析的自变量进行分析后得知,病理类型恶性、气管食管沟淋巴结双侧清扫、术前PTH降低、未使用纳米碳示踪剂为术后甲状旁腺损伤的主要影响因素(P<0.05)。结论:甲状腺肿瘤小切口术后出现甲状旁腺损伤的主要危险因素为肿瘤性质(恶性)、气管食管沟淋巴结双侧清扫、未使用纳米碳示踪剂、术前PTH降低,临床需根据此类危险因素实施相应预防措施。Objective:To investigate the influence factors of parathyroid gland injury after small incision surgery for thyroid tumors.Method:A total of 120 patients who underwent small incision surgery for thyroid tumors admitted to Pinghe County Hospital from March 2020 to December 2021 were selected as study subjects.According to the parathyroid hormone(PTH)level on the first day after surgery,they were divided into hypoparathyroidism group(PTH<15 pg/mL,n=42)and parathyroid gland function normal group(PTH 15-65 pg/mL,n=78).The data of patients were analyzed,univariate and multivariate logistic regression analysis were used to analyze the main risk factors for postoperative parathyroid injury.Result:There were statistically significant differences between two groups in terms of age,lesion diameter,tracheoesophageal groove lymph node dissection,pathological type,preoperative PTH,and no use of nanocarbon tracers(P<0.05).After analyzing the factors with statistically significant differences in univariate analysis as independent variables in multivariate logistic regression analysis,it was found that the main influencing factors for postoperative parathyroid gland injury were malignant pathological type,bilateral dissection of tracheoesophageal sulcus lymph nodes,decreased preoperative PTH,and the absence of use of nanocarbon tracers(P<0.05).Conclusion:The main risk factors of parathyroid injury after small incision surgery for thyroid tumor are the nature of the tumor(malignant),bilateral tracheoesophageal groove lymph node dissection,no use of nano carbon tracer and preoperative PTH reduction,clinical prevention measures should be taken according to these risk factors.

关 键 词：甲状腺 肿瘤小切口术 甲状旁腺 损伤 因素 淋巴结 清扫 

分 类 号：R736.1[医药卫生—肿瘤]