CAJ | 학술논문

目的：总结甲状腺全切除术中甲状旁腺功能的保护方法。方法回顾性分析2009年10月至2014年6月收治的42例行甲状腺全切除术患者的临床资料，比较手术前后血清甲状旁腺激素（PTH）、血钙水平变化。结果术后PTH暂时低下者19例（45.2%），低钙血症者9例（21.4%），术后30 d复查血清PTH及血钙均恢复正常，未见永久性甲状旁腺功能低下的病例。术后第1、3、5天，血清PTH较术前明显降低（P<0.05），而术后30 d，血清PTH与术前无显著性差异（P>0.05）。血钙水平除了术后第1天、第3天低于术前（P<0.05），其余时间点与术前均无显著性差异（P>0.05）。结论甲状腺全切除术中加强对甲状旁腺解剖位置的辨别、血供的保护，可有效减少术后甲状旁腺的损伤，避免严重并发症的发生。
목적：총결갑상선전절제술중갑상방선공능적보호방법。방법회고성분석2009년10월지2014년6월수치적42례행갑상선전절제술환자적림상자료，비교수술전후혈청갑상방선격소（PTH）、혈개수평변화。결과술후PTH잠시저하자19례（45.2%），저개혈증자9례（21.4%），술후30 d복사혈청PTH급혈개균회복정상，미견영구성갑상방선공능저하적병례。술후제1、3、5천，혈청PTH교술전명현강저（P<0.05），이술후30 d，혈청PTH여술전무현저성차이（P>0.05）。혈개수평제료술후제1천、제3천저우술전（P<0.05），기여시간점여술전균무현저성차이（P>0.05）。결론갑상선전절제술중가강대갑상방선해부위치적변별、혈공적보호，가유효감소술후갑상방선적손상，피면엄중병발증적발생。
Objective To summarize the protection method of parathyroid glands in total thyroidectomy. Methods Clinical data of 42 patients who were treated by total thyroidectomy in our hospital from 2009.10 to 2014.6 were retrospectively analyzed. The level of serum PTH and calcium before and after surgery were compared. Result 19 cases (45.2%)had decreased PTH and 9 cases(21.4%)had complicated symptomatic hypocalcemia,but the level of serum PTH and calcium return to normal at 30 days after surgery. Perpetual hypoparathyroidism was not found. The level of serum PTH was significantly decreased(P<0.05),while there was no difference at 30 days after surgery(P>0.05),and without difference on the level of serum calcium except that at 1st and 3rd day after surgery,as compared to that before surgery. Conclusions Identify of parathyroid anatomical location and protection of blood supply in total thyroidectomy can effectively reduce postoperative parathyroid damage,avoid severe complications.