甲状腺全切术后并发永久性甲状旁腺功能减退症的危险因素分析  

Analysis of risk factors for permanent hypoparathyroidism after total thyroidectomy

作　　者：李洲成 向元楚 肖聪 LI Zhoucheng;XIANG Yuanchu;XIAO Cong(Department of Breast and Thyroid Surgery,The Second Affiliated Hospital of Shaoyang University,Shaoyang 422000,China)

机构地区：[1]邵阳学院附属第二医院乳甲外科,湖南邵阳422000

出　　处：《邵阳学院学报(自然科学版)》2024年第6期94-99,共6页Journal of Shaoyang University:Natural Science Edition

基　　金：湖南省教育厅一般项目(22C0461)。

摘　　要：目的探讨甲状腺全切术后并发永久性甲状旁腺功能减退症(hypoparathyroidism,HP)的危险因素及术后第1天血甲状旁腺激素(parathyroid hormone,PTH)水平的预测价值。方法纳入2022年1月至2024年1月于邵阳学院附属第二医院接受甲状腺全切术的患者100例。采用单因素及多因素分析评估危险因素,根据受试者操作特征曲线(ROC曲线)评价术后第1天血PTH水平的预测价值。结果单因素分析结果显示,永久性HP与术后第1天血PTH水平、术后第1天血钙水平、中央区淋巴结清扫、纳米碳使用、肿瘤最大径、甲状腺最大径有关(P<0.05)。多因素分析结果显示,术后第1天血PTH水平、术后第1天血钙水平是甲状腺全切术后并发永久性HP的独立危险因素。ROC曲线分析结果显示,术后第1天血PTH水平预测永久性HP的效能高于术后第1天血钙水平。结论甲状腺全切术后第1天血PTH水平低及术后第1天血钙低更易发生永久性HP,且术后第一天血PTH水平的预测效能更高。Objective To investigate the risk factors for permanent hypoparathyroidism(HP)after total thyroidectomy and to assess the value of serum parathyroid hormone(PTH)levels measured on the first day after surgery in predicting permanent HP.Methods A total of 100 patients who underwent total thyroidectomy at The Second Affiliated Hospital of Shaoyang University from January 2022 to January 2024 were included.They were divided based on whether they developed permanent HP after surgery.Univariate and multivariate analyses were employed to identify risk factors associated with permanent HP.The predictive value of serum PTH levels measured on the first postoperative day was evaluated using a receiver operating characteristic(ROC)curve.Results The univariate analysis indicated that permanent HP was correlated with PTH and serum calcium levels on the first day after surgery,as well as factors such as central lymph node dissection,nano-carbon use,tumor maximum diameter,and thyroid maximum diameter(P<0.05).The multivariate analysis identified serum PTH and serum calcium levels on the first day after surgery as independent risk factors for permanent HP after surgery.Additionally,the ROC curve showed that the serum PTH level on the first day after surgery was more effective in predicting permanent HP than the serum calcium level.Conclusion Low serum PTH and calcium levels on the first day after surgery significantly increase the likelihood of developing permanent HP.Moreover,the serum PTH levels measured on the first day after surgery have a superior predictive capability compared to serum calcium levels.

关 键 词：甲状腺全切术 永久性甲状旁腺功能减退症 血钙 

分 类 号：R653[医药卫生—外科学]