彭喆, 田文, 姚京, 张艳君, 李晨, 菅雁兵, 史成燕. 中央区淋巴结清扫术对甲状腺乳头状癌患者甲状旁腺功能的影响[J]. 解放军医学院学报, 2014, 35(7): 684-687. DOI: 10.3969/j.issn.2095-5227.2014.07.011
引用本文: 彭喆, 田文, 姚京, 张艳君, 李晨, 菅雁兵, 史成燕. 中央区淋巴结清扫术对甲状腺乳头状癌患者甲状旁腺功能的影响[J]. 解放军医学院学报, 2014, 35(7): 684-687. DOI: 10.3969/j.issn.2095-5227.2014.07.011
PENG Zhe, TIAN Wen, YAO Jing, ZHANG Yan-jun, LI Chen, JIAN Yan-bing, SHI Cheng-yan. Clinical study of the effect of central lymph node dissection on cN0 papillary thyroid carcinoma patients' parathyroid function[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2014, 35(7): 684-687. DOI: 10.3969/j.issn.2095-5227.2014.07.011
Citation: PENG Zhe, TIAN Wen, YAO Jing, ZHANG Yan-jun, LI Chen, JIAN Yan-bing, SHI Cheng-yan. Clinical study of the effect of central lymph node dissection on cN0 papillary thyroid carcinoma patients' parathyroid function[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2014, 35(7): 684-687. DOI: 10.3969/j.issn.2095-5227.2014.07.011

中央区淋巴结清扫术对甲状腺乳头状癌患者甲状旁腺功能的影响

Clinical study of the effect of central lymph node dissection on cN0 papillary thyroid carcinoma patients' parathyroid function

  • 摘要: 目的 观察中央区淋巴结清扫术对甲状腺乳头状癌患者术后甲状旁腺功能的影响。 方法 对2007年12月- 2011年11月在解放军总医院普通外科住院期间由同一主诊组施行全甲状腺切除术的127例甲状腺乳头状癌患者的临床资料进行回顾性分析。 结果 实验组(行中央区淋巴结清扫术)术后暂时性甲状旁腺功能低下,术后24 h全段甲状旁腺激素及血钙低于正常的发生率高于对照组(未行中央区淋巴结清扫术)(P< 0.05),两组均未出现永久性甲状旁腺功能低下。 结论 中央区淋巴结清扫术可增加甲状腺乳头状癌患者术后暂时性甲状旁腺功能低下的发生率,但并不增加永久性甲状旁腺功能低下的发生率。在手术中应注意避免对甲状旁腺腺体的直接损伤,并注意对其血供系统的保护。

     

    Abstract: Objective To investigate the effect of central lymph node dissection on papillary thyroid carcinoma patients' parathyroid function. Methods Clinical data about 127 patients with papillary thyroid carcinoma who underwent total thyroidectomy by the same operation group during their hospitalization from December 2007 to November 2011 in the department of general surgery of Chinese PLA general hospital were retrospectively analyzed. Results The incidence of hypoparathyroidism, subnormal of 24 hours postoperative intact parathyroid hormone and 24 hours postoperative serum calcium in experimental group (with central lymph node dissection) were signifcantly higher than those in the control group (without lymph node dissection) (P< 0.05). There were no permanent hypoparathyroidism cases in both of the two groups. Conclusion Central lymph node dissection increases the incidence of postoperative hypoparathyroidism in papillary thyroid carcinoma patients, however, it does not increase the incidence of postoperative permanent hypoparathyroidism. Surgeon in this operation should pay attention to avoiding direct damage to the parathyroid and also to the protection of the blood supply of parathyroid.

     

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