甲状腺全切除手术中甲状腺旁腺保护.docVIP

甲状腺全切除手术中甲状腺旁腺保护 　　[摘要] 目的 探讨甲状腺全切除手术中精细解剖对甲状腺旁腺的保护作用。方法 随机将方便选取2007年1月―2015年12月该院收治的112例行甲状腺全切的患者均分为两组。对照组术中不解剖甲状旁腺；实验组术中精细解剖甲状旁腺。观察两组术后PTH和血清Ca2+水平变化情况。结果 实验组末次检测PTH （43.14±12.50），血清Ca2+ （2.20±0.05），对照组末次检测PTH （37.09±8.40），血清Ca2+ （2.07±0.06）；实验组甲状腺功能减退率（14.29%）和低血钙症发生率（5.36%）也均低于对照组差异有统计学意义（P0.05）。结论 精细解剖在甲状腺全切术中的应用能很好的保护甲状旁腺，对维持患者术后甲状旁腺激素水平具有重要意义，值得推广使用。 　　[关键词] 甲状腺全切术；甲状旁腺；精细解剖 　　[中图分类号] R736 [文献标识码] A [文章编号] 1674-0742（2016）10（a）-0072-03 　　Thyroid Glands in Thyroid Surgery to Remove All Protection 　　CHENG Shun-zhou， WANG Hai-yan 　　Department of Thyroid and Breast Surgery， Jiangning Hospital， Nanjing， Jiangsu Province， 211100 China 　　[Abstract] Objective To investigate the protective effect of fine dissection of the thyroid gland in total thyroidectomy .Methods Convenient selection randomly divided into 112 cases in January 2007 to December 2015 were divided into two groups of patients with total thyroidectomy. In the control group， the parathyroid glands were not dissected during operation， and the fine dissected parathyroid glands were dissected in the experimental group. The changes of PTH and serum Ca2+ levels were observed in two groups after operation. Results The experimental group at the end of the detection of PTH （43.14±12.50）， serum Ca2+ （2.20±0.05）， the control group at the time of the last detected PTH （37.09±840）， serum Ca2+（2.07±0.06）； experimental group， the thyroid function loss rate （14.29%）， and hypocalcemia occurred rate （5.36%） were lower than those of the control group.the difference was staristically significant（P0.05）. Conclusion The application of fine dissection in total thyroidectomy can protect the parathyroid gland very well， which is of great significance for the maintenance of the parathyroid hormone level in the patients. 　　[Key words] Total thyroidectomy； Parathyroid gland； Fine dissection； Protective effect 　　甲状腺全切术是临床治疗甲状腺癌及恶性淋巴瘤的常用手术方法。实践证实，传统手术应用虽具备临床疗效，却易给喉返神经和甲状旁腺造成损伤，特别是甲状旁腺，数据统计甲状腺全切术中其损伤率最高可达35%，严重影响患者预后。有报道显