Journal of Hebei Medical University

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Analysis of the related factors of the effect of total thyroidectomy on parathyroid function

  

  1. Department of Thyroid and Breast Surgery, the Second Hospital Affiliated to Hebei Medical University, Shijiazhuang 050000, China
  • Online:2016-10-25 Published:2016-11-04

Abstract: [
Abstract ] Objective Toassessthevarietyandsignificanceofserumcalcium , magnesium ,
phosphorus , parathyroidhormone ( PTH ), andrelatedclinicalriskfactorsofparathyroidinjury
aftertotalthyroidectomy.Methods One hundred and twenty-nine patients with total
thyroidectomy , consistingof82caseswiththyroidpapillarycarcinomaand47caseswithNodular
goiterandthyroidadenoma , wereretrospectivelystudied.Levelsofserumcalcium , magnesium ,
inorganicphosphorusandPTHbeforeoperationand30minutes , 1d , 3dafteroperationwere
measuredrespectively , andage , gender , preoperativethyroidstimulating hormone (
TSH ),
intraoperativeidentificationofparathyroidglands , pathologicdiagnosiswerecounted.Andthen
therelationshipbetweentheabovefactorsandhypocalcemiawhichaffectedbyparathyroidinjury
afteroperationwereanalyzedrespectively.Results Serumcalcium , magnesiumandPTHlevels
afteroperationintotalthyroidectomypatients werealllowerthanthosebeforeoperation ,
especiallyserumcalciumandmagnesiumlevelsin1dayafteroperationdecreasedsignificantly ,
andserumPTHlevelsdeclinedin30minutesafteroperation.Therewerestatisticallysignificant differencesonserumcalciumlevelsindifferentthyroidectomygroupsordifferenttimepoints
(
P <0.05 ), buttherewasnosignificantinteractionbetweenthetwogroupsatthesametime
P >0.05 ) .Andtherewerealsostatisticallysignificantdifferencesonserum magnesiumandPTH
indifferentgroups , differenttimepointsandtheinteractionbetweenthetwogroups ( P <0.05 ),
whiletherewasnosignificantdifferenceintheinteractionofserum phosphorusindifferent
groupsofallthegroups , betweendifferentpoints , andbetweenthetwogroups ( P >0.05 ) .
Among129caseswithtotalthyroidectomy , 77cases ( 59.7% ) werenormalserumcalcium , 31
cases ( 24.0% ) wereasymptomatichypocalcemia , and21casesweresymptomatichypocalcemia.
Theriskofhypocalcemiathyroidcancerunderwenttotalthyroidectomygroupaftersurgerywas
significantlyhigherthanthatinbenignthyroiddiseasegroup ( P <0.05 ) .Theidentification
numberandtheage , gender , parathyroidsurgerypreoperative TSH levelandpostoperative
hypocalcemiawerenotstatisticallysignificant ( P >0.05 ) .Conclusion Thescopeofoperationand
thyroidcancermaybetheinfluencingfactorsofparathyroidinjuryafteroperation.Afterthyroid
surgery , bloodPTH monitoringismoresensitivethanserumcalcium monitoring.Lowserum
calciumafterthyroidsurgeryisoftenaccompanywithlowserum magnesium , soserumcalcium
supplementneedsserum magnesiumsupplementatthesametime.

Key words: totalthyroidectomy , parathyroidinjury , hypocalcemia