全甲状腺切除术中甲状旁腺原位保留的临床研究

目的探讨在全甲状腺切除术中，行甲状旁腺原位保留对降低甲状旁腺功能减低与低钙血症发生率的临床价值。方法选择154例行全甲状腺切除术的甲状腺癌患者，将其随机分为传统手术组和术中行甲状旁腺原位保留组，比较两组患者术后发生甲状旁腺功能减低及低钙血症的发生率。结果两组患者均无永久性甲状旁腺功能减退的发生。行甲状旁腺原位保留纽患者出现暂时性的甲状旁腺功能减低1例（1．32％），血钙水平降低5例（6．58％）。而传统手术组则分别为4例（5．13％）、13例（16．7％）。术后两组患者甲状旁腺功能减低及低钙血症的发生率差异均有统计学意义（P〈0．05）。结论全甲状腺切除术中，行甲状旁腺原位保留可有效降低甲状旁腺功能减低及低钙血症的发生率。

Clinical research of keeping parathyroid in situ in total thyroidectomy

Objective To investigate the clinical value of keeping parathyroid in situ on reduc-ing the incidence of hypoparathyroidism and hypocalcemia during total thyroidectomy. Methods One hundred and fifty-four patients underwent total thyroidectomy were divided into two groups randomly, one group was given normal surgery, and the other group was kept parathyroid in situ. And then the inci-dences of hypoparathyroidism and hypocalcemia after surgery were compared. Results There was no single permanent parathyroid function during the two groups. There was 1 case （ 1.32% ） of hypo- para thyroidism and 5 cases （6.58%）of hypocalcemia in the patients who were kept parathyroid in situ. There were 4 cases （5. 13 % ） of hypoparathyroidism and 13 cases （ 16.7% ） of hypocalcemia in the patients who were given normal surgery. There were significant differences between the two groups in the incidences of hypoparathyroidism and hypocalcemia（P 〈 0.05）. Conclusions Keep-ing parathyroid in situ during total thyroidectomy can reduce the incidences of parathyroid function and hypocalcemia effectively.