不同甲状腺手术方式对患者甲状旁腺素和血钙水平的影响

目的 探讨不同甲状腺手术方式对患者甲状旁腺素（PTH）和血钙水平的影响.方法 选取行甲状腺手术的患者264例,按术式的不同分为A、B、C、D、E、F、G 7个组,观察各组术前及术后血清PTH、血钙水平,及低血PTH、低血钙和症状性低钙血症的发生情况.结果 7组患者术后血清PTH、血钙水平均显著下降（P＜0.01）.E、G组患者血清PTH水平差值显著高于C、D、F组（P＜0.01）,C、D、F组显著高于A、B组（P＜0.01）;D、E、G、F患者血钙水平差值显著高于C组（P＜0.01）,C组显著高于A、B组（P＜0.01）.E、F、G组低血PTH发生率高,C、D、E、F、G组低血钙和症状性低钙血症的发生率较高.结论 甲状腺切除范围及颈淋巴结清扫范围越大,术后发生甲状旁腺功能减退及低血PTH、低血钙和症状性低钙血症的可能性越大.

Effects of different ways of thyroid surgery on the levels of parathyroid hormone and blood calcium of patients

Objective To explore the effects of different ways of thyroid surgery on the levels of parathyroid hormone （PTH） and blood calcium of patients.Methods A total of 246 patients performed with thyroid surgery were selected and divided into A,B,C,D,E,F and G groups according to surgical methods.Serum PTH and blood calcium before and after surgery and the occurrence rate of low PTH,blood calcium and symptomatic hypocalcemia were observed.Results Serum PTH and blood calcium after surgery of 7 groups decreased more significantly than before surgery （P 〈 0.01）.The levels of PTH of patients in E and G groups were obviously higher than C,D and F groups （P 〈 0.01） and C,D and F groups were higher than A and B groups （P 〈0.01）.The levels of blood calcium of patients in D,E,G and F groups were higher than C group （P 〈 0.01） and C group was higher than A and B groups （P 〈 0.01）.The occurrence rate of low PTH of patients in E,F and G groups were higher and C,D,E,F and G groups were relatively higher in the occurrence rate of low blood calcium and symptomatic hypocalcemia.Conclusion The larger thyroid excision extension lymphonodi cervicales cleaning scope is,the greater the likelihood of hypoparathyroidism and lower PTH,blood calcium and symptomatic hypocalcemia will be.