Risk factors of hypoparathyroidism following total or near total thyroidectomy
10.3760/cma.j.issn.0529-5815.2016.03.011
- VernacularTitle:甲状腺全切除术和近全切除术术后甲状旁腺功能损伤的危险因素分析
- Author:
Tianxiao WANG
1
;
Wenbin YU
;
Xiao MA
;
Yuntao SONG
;
Naisong ZHANG
Author Information
1. 100142,北京大学肿瘤医院 北京市肿瘤防治研究所头颈外科 恶性肿瘤发病机制及转化研究教育部重点实验室
- Keywords:
Thyroidectomy;
Hypoparathyroidism;
Hypocalcemia
- From:
Chinese Journal of Surgery
2016;54(3):206-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the risk factors for postoperative hypoparathyroidism or hypocalcemia.Methods Totally 414 patients with thyroid diseases who underwent total or near total thyroidectomy at Department of Head and Neck Surgery,Peking University Cancer Hospital and Institute from June 2007 to June 2014 were studied retrospectively.There were 119 male and 295 female patients with a median age of 47 years.The clinical and pathological features that related to post-operative hypoparathyroidism were studied by x2 test and multivariate Logistic regression analysis.Results Of the 414 patients,36.2％ developed transient hypocalcemia,36.5％ developed transient hypoparathyroidism,2.2％ developed permanent hypoparathyroidism.In regression analysis,unilateral or bilateral center lymph node dissection were associated with mild transient hypocalcemia after surgery (OR =2.366,P =0.022;OR =5.216,P =0.000);unilateral or bilateral center lymph node dissection as well as surgical options were significant risk factors for severe transient hypocalcemia (OR =4.029,P =0.001;OR =8.384,P =0.000;OR=2.073,P =0.017) and hypoparathyroidism (OR =1.755,P =0.040;OR =4.144,P =0.000;OR =2.287,P =0.000).The parathyroid hormone concentration on postoperative day 1 was an independent risk factor for permanent hypoparathyroidism (OR =2.011,P =0.014).The concentration of parathyroid hormone threshold ＜ 5.28 ng/L was a predictor to permanent hypoparathyroidism with accuracy of 95.0％.Conclusions Bilateral center lymph node dissection is a risk factor of permanent hypoparathyroidism in patients received total thyroidectomy should be taken thoughtfully.The parathyroid hormone concentration on postoperative day 1 provides better prediction for persistent hypoparathyroidism.
