Objective To explore the changes and influencing factors of PTH(Parathyroid hormone)levels after the total thy-roidectomy,and provide the theoretical basis for predicting the occurrence and treatment of hypocalcemia symptoms.Methods A retro-spective analysis was conducted on 173 patients with total thyroidectomy,who were divided into four groups according to specific surgical methods:Group A(87 cases)underwent total thyroidectomy or total thyroidectomy with unilateral Ⅵ lymph node dissection,Group B(38 cases)underwent total thyroidectomy with bilateral Ⅵ lymph node dissection,Group C(34 cases)underwent total thyroidectomy with parathyroid gland transplantation or total thyroidectomy with unilateral Ⅵ neck dissection and parathyroid gland transplantation,Group D(14 cases)underwent total thyroidectomy with bilateral Ⅵ lymph node dissection and parathyroid gland transplantation.The changes levels of calcium and PTH in the blood were dynamically monitored before and after surgery.Results Out of 173 postoperative cases,107 cases showed a decrease in PTH levels,while 66 cases showed normal results.The incidence rate of temporary hypothyroidism(T-HPT)was 61.85％.Univariate analysis showed that the occurrence of T-HPT after surgery was correlated with female gender,sur-gical method,number of central lymph node dissection≥4,parathyroid gland misresection,multiple lesions,and postoperative calcium supplementation,with statistically significant differences(P＜0.05).Logistic multivariate regression analysis showed that gender,surgi-cal method,parathyroid gland resection,and the presence of Hashimoto's thyroid or thyroid nodules were risk factors for postoperative T-HPT,with statistically significant differences(P＜0.05).Conclusion Gender,surgical methods,parathyroid gland resection,combined with Hashimoto's thyroiditis or thyroid nodules are the related risk factors for postoperative T-HPT.Measure the blood PTH value on the first day after surgery can predict the occurrence of hypocalcemia after surgery.
维普
万方数据
