Analysis of risk factors for hypocalcemia after total thyroidectomy / 中华内分泌外科杂志

ABSTRACT

Objective To evaluate the influencing factors for hypocalcemia after total thyroidectomy in thyroid carcinoma.Methods 650 patients with thyroid carcinoma undergoing total thyroidectomy from Jun.2009 to Dec.2011 were followed up and analyzed retrospectively.The relativity between persistent hypocalcemia and the following criteria were studiedage, sex, primary tumor stage, initial thyroid treatment, neck dissection cen-tral compartment dissection, inadvertent parathyroidectomy, and thyroid caspsular dissection.χ2test was used to analyze the statistical correlation between hypocalcemia after total thyroidectomy and the other clinical factors. Multiple logistic regression analysis was used to identify the multivariate correlation of clinical factors and hypocal-cemia after total thyroidectomy. Results Persistent hypocalcemia was found in 112 out of 650 patients (17.2%).Advanced stage(OR=2.121,95%CI 1.140-3.947,P=0.018),bilateral central compartment dis-section(OR=1.852,95% CI 1.199 -2.863,P =0.006),failure to use thyroid caspsular dissection(OR =2.307,95%CI 1.208-4.405,P=0.011)and IPE(OR=1.580,95%CI 1.029-2.427,P=0.037)were inde-pendent predictive factors for hypocalcemia after total thyroidectomy.Conclusions It has high incidence of persis-tent hypocalcemia in patients with andvanced-stage thyroid carcinoma after going total thyroidectomy.Thyroid caspsular dissection method, proper indications for bilateral central compartment dissection, and reducing IPE can help to reduce the incidence of persistent hypocalcemia and improve the life quality of patients after going thyroidectomy.