甲状腺癌患者术后并发暂时性甲状旁腺功能低下的相关因素分析  

Analysis of Related Factors of Temporary Hypoparathyroidism in Thyroid Cancer

作　　者：姚俊[1] 丁芮 袁文明[1] 郑守华[1] YAO Jun;DING Rui;YUAN Wenming(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2024年第2期237-240,共4页The Practical Journal of Cancer

摘　　要：目的探讨甲状腺癌患者术后并发暂时性甲状旁腺功能低下(tHPP)的相关因素。方法回顾性分析72例甲状腺癌患者临床资料。所有患者均开展手术治疗,依据术后是否发生tHPP分为tHPP组与非tHPP组。收集2组年龄、性别、体质量指数、肿瘤长径、手术方式、肿瘤侧别、临床分期、淋巴结清扫范围、甲状旁腺误切、术前维生素D水平、纳米炭示踪剂等临床资料,分析患者术后并发tHPP的独立危险因素。结果72例甲状腺癌患者术后18例发生tHPP,发生率为25.00%(18/72)。单因素分析显示,肿瘤长径、手术方式、肿瘤侧别、临床分期、淋巴结清扫范围、甲状旁腺误切、术前维生素D水平、纳米炭示踪剂与患者术后并发tHPP相关(P<0.05);多因素分析显示,肿瘤长径≥4 cm、开放性手术、双侧肿瘤、临床分期Ⅲ~Ⅳ期、淋巴结清扫范围双侧、甲状旁腺误切、术前维生素D水平<26 ng/ml、未使用纳米炭示踪剂为患者术后并发tHPP的独立危险因素(OR>1,P<0.05)。结论肿瘤长径≥4 cm、开放性手术、双侧肿瘤、临床分期Ⅲ~Ⅳ期、淋巴结清扫范围双侧、甲状旁腺误切、术前维生素D水平<26 ng/ml、未使用纳米炭示踪剂为甲状腺癌患者术后并发tHPP的高危因素,临床需尽早识别该类因素,采取针对性预防措施,以减少tHPP的发生。Objective To investigate the related factors of concurrent temporary hypoparathyroidism(tHPP)in postoperative thyroid cancer patients.Methods The clinical data of 72 thyroid cancer patients were also retrospectively analyzed.All patients underwent surgical treatment and were divided into tHPP groups and non-tHPP groups based on whether tHPP occurred after surgery.Clinical data on age,sex,body mass index,tumor length,surgical method,tumor side,clinical stage,lymph node dissection range,parathyroid mis-resection,preoperative vitamin D level and nanocar tracer were collected to analyze independent risk factors of concurrent tHPP after surgery.Results 18 postoperative tHPP occurred in 72 patients with thyroid cancer,The incidence rate was 25.00%(18/72);As the univariate factor showed that the tumor length,surgical method,tumor side division,clinical stage,lymph node dissection range,parathyroid mis-resection,preoperative vitamin D level,nanocarp tracer were associated with postoperative concurrent tHPP,The difference was statistically significant(P<0.05);Multiple factors showed that tumor long diameter of 4 cm,open surgery,bilateral tumors,clinical stage-stage,bilateral lymph node dissection range,parathyroid mis-resection,preoperative vitamin D level<26 ng/ml,and absence of nanometer carbon tracer were independent risk factors for the postoperative tHPP(OR>1,P<0.05).Conclusion Tumor long diameter of 4 cm,open surgery,bilateral tumor,clinical stage-stage,lymph node dissection range bilateral,parathyroid mis-resection,preoperative vitamin D level<26 ng/ml,no nanometer carbon tracer as the risk factor of postoperative tHPP in thyroid cancer patients,clinical need to identify these factors as soon as possible and take targeted preventive measures to reduce the occurrence of tHPP.

关 键 词：甲状腺癌 甲状腺癌根治术 暂时性甲状旁腺功能低下 影响因素 

分 类 号：R736.1[医药卫生—肿瘤]