甲状腺全切术中医源性甲状旁腺功能减退的防治

目的：总结甲状腺全切术中医源性甲状旁腺功能减退的防治经验。方法回顾性分析苏州大学附属第三医院肝胆外科甲状腺专业组2010年1月至2012年12月间377例甲状腺全切术患者的临床资料。结果术后无永久性甲状旁腺功能减退发生，暂时性甲状旁腺功能减退的发生率为13.79％（52/377），暂时性低钙血症的发生率为10.61％（40/377）。结论术中采用精细被膜解剖原位保护甲状旁腺及其血供，术后改善微循环及适量预防性补钙可有效预防医源性甲状旁腺功能减退。

The prevention and treatment of iatrogenic hypoparathyroidism in total thyroidectomy

Objective To summarize the experience of the prevention and treatment of iatrogenic hypo-parathyroidism in total thyroidectomy .Methods 377 patients received total thyroidectomy performed by the Thy-roid Professional Group of Hepatobiliary Surgery Department of the Third Affiliated Hospital of Soochow University from Jan.2010 to Dec.2012.Their clinical date were retrospectively analyzed .Results There was no perma-nent postoperative hypoparathyroidism .The incidence of temporary hypoparathyroidism was 13.79%（ 52/377 ） . The occurrence of transient hypocalcemia was 10.61%（ 40/377 ） .Conclusions Iatrogenic hypoparathyroidism can be prevented by intraoperative in situ protection of parathyroid glands and their blood supply using fine cap -sule anatomy method .Postoperative improvement of microcirculation and calcium supplement also help prevent postoperative hypoparathyroidism .