摘要
目的:探讨甲状腺全切及近全切术中甲状旁腺及其功能的保护。方法:对131例行甲状腺全切、近全切术及甲状腺腺叶及峡部切除术患者在术中显露甲状旁腺,必要时在显微镜下识别、结扎甲状腺下动脉第3级血管,原位保护甲状旁腺,观察术后甲状旁腺功能情况。结果:4例(3%)术后出现暂时性甲状旁腺功能低下;26例(20%)血钙明显降低无症状;73例(56%)术后3d内血钙水平较术前一过性降低;28例(21%)甲状腺腺叶加峡部切除或甲状腺腺叶加对侧部分切除患者,术后血钙均在正常范围。所有患者均未发生永久性甲状旁腺功能低下,无死亡患者。结论:甲状腺全切及近全切术中辨认和保护甲状旁腺及其血液供应,术后对血钙明显降低者适量应用扩血管药物及补充钙剂,可有效防止术后永久性甲状旁腺功能低下的发生。
Objective.. To investigate the preservation of parathyroid glands and its function during total or near-total thyroidectomy. Method： One hundred and thirty one patients underwent total thyroidectomy, near total thyroidectomy, hemithyroidectomy and isthmectomy. In operation, the parathyroid glands were exposed, or were identified under microscope when necessary. The third rank of inferior thyroid arteries was ligated to preserve parathyroid glands in situ, and the parathyroid function was observed after thyroidectomy. Result：Four patients（3%） had a transient hypoparathroidism after thyroidectomy, 26 patients（20% ）had a obviously biochemical hypocalcemia with no symptoms, 73 patients （56%） had a lower calcium level in the first 3 days after surgery compared with preoperative level, 28（21%） patients who underwent ipsilateral total and contralateral subtotal isthmectomy were all normocalcemic after surgery. There were no permanent hypoparathroidism and death in our study population. Conclusion：In total or near-total thyroidectomy, parathyroid glands and its artery blood-supply should be exposed and preserved. Vasodilator and calcium supplementation should be given to patients with obviously lower serum calcium level after surgery to prevent permanent hypoparathroidism.
出处
《临床耳鼻咽喉科杂志》
CAS
CSCD
北大核心
2006年第21期980-982,共3页
Journal of Clinical Otorhinolaryngology
