Analysis of changes in parathyroid hormone levels and influencing factors in patiehs with thyroid cancer affer total fhyroidectomy
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.
万方数据
维普
