Effect of different operation methods on parathyroid function and hypocalcemia in postoperative patients ;with thyroid cancer / 中国基层医药

ABSTRACT

Objective To provide the basis for clinical treatment by compared the effect of different opera-tion methods on parathyroid function and hypocalcemia in postoperative patients with thyroid cancer.Methods Selected 120 patients with thyroid cancer who underwent total thyroidectomy or subtotal thyroidectomy from January 2009 to December 2014,and they were divided into A group(underwent thyroid gland lobe +isthmus resection +side lobe subtotal resection),B group(underwent total thyroidectomy)and C group(underwent total thyroidectomy +uni-lateral/bilateral neck dissection).Then detected the levels of serum calcium and parathyroid hormone(PTH)of all patients before operation,1d after operation and 4d after operation respectively,and observed the incidence of symp-tomatic hypocalcemia in the patients after surgery.Results Compared with before operation,the serum PTH and ser-um calcium in three groups 1d,4d after operation were significantly decreased,and those of B group and C group were lower than A group,the differences were statistically significant(all P <0.05).The incidence rates of low PTH,hy-pocalcemia and symptomatic hypocalcemia were 70.37%,62.96%,48.15% respectively in C group after operation, which were significantly higher than 33.33%,33.33%,21.43% in B group and 15.69%,25.49%,5.88% in A group,the differences were statistically significant(χ2 =23.490,10.984,22.385,all P <0.05).The difference of incidence of low PTH in C group was significant compared with A group and B group (χ2 =23.325,P <0.001;χ2 =9.035,P =0.002).The difference of incidence of hypocalcemia in C group was significant compared with A group and B group (χ2 =10.474,P =0.001;χ2 =5.831,P =0.015).The difference of incidence of symptomatic hypocal-cemia in C group was significant compared with A group and B group (χ2 =19.342,P <0.001;χ2 =5.403,P =0.020).Conclusion Different operation methods can affect the parathyroid function and the level of serum calcium, and the effect become larger alone with the larger of operation range,which is worthy of clinical reference.