甲状腺术式对术后低钙血症的影响

Influence of Thyroid Surgical Approaches to Postoperative Hypocalcaemia

摘要: 目的：探讨不同甲状腺术式导致术后低钙血症的原因和预防方法。方法：回顾性分析我科近5年来的1128例甲状腺手术患者，根据不同术式给予分组，并对各组出现的低钙血症例数进行统计分析。结果：甲状腺全切合并颈淋巴结清扫出现低钙血症的比例明显升高。结论：良性病变保留甲状腺后背膜的切除术可减少低钙血症的发生率，恶性病变术中解剖应注意保护甲状旁腺血供，清扫淋巴结时不慎切除甲状旁腺后可再次将其移植入胸锁乳突肌。

Abstract: Objective: To explore the reasons of postoperative hypocalcaemia after different surgeries of thy-roid gland and find the prevention methods. Methods: Retrospectively 1128 cases with thyroid gland treated in our hospital from 2010 to 2015 were analyzed. Patients were grouped according to different surgical methods, and the number of hypocalcaemia cases of each group was analyzed. Results: The incidence of postoperative hypocalcaemia in total thyroidectomy plus lymphadenec-tomy was significantly high. Conclusion: In the treatment of benign thyroid diseases, the incidence of hypocalcaemia is lower if the membrane behind thyroid is retained. On the contrary, for the malignant disease, it should pay attention to avoid harming parathyroid’s blood supply when op-erating. If parathyroid glands are excised accidentally in the lymphadenectomy, it’s necessary to transplant parathyroid into the sternocleidomastoid muscle.