Chinese General Practice ›› 2022, Vol. 25 ›› Issue (23): 2869-2873.DOI: 10.12114/j.issn.1007-9572.2022.0210

• Article • Previous Articles     Next Articles

Influencing Factors of Hypoparathyroidism in Patients with Differentiated Thyroid Carcinoma after Radical Thyroidectomy

  

  1. 1The First Clinical Medicine College of Gansu University of Chinese Medicine, Lanzhou 730000, China
    2Department of General Surgery, 940 Hospital of PLA Joint Logistics Support Force, Lanzhou 730050, China
    3Department of General Surgery, Gansu Central Hospital, Lanzhou 730070, China
  • Received:2022-01-04 Revised:2022-04-06 Published:2022-08-15 Online:2022-04-28
  • Contact: Xiaopeng HAN
  • About author:
    LU S L, YU J P, LI H T, et al. Influencing factors of hypoparathyroidism in patients with differentiated thyroid carcinoma after radical thyroidectomy[J]. Chinese General Practice, 2022, 25 (23) : 2869-2873.

分化型甲状腺癌患者行甲状腺癌根治术后发生甲状旁腺功能减退的影响因素研究

  

  1. 1730000 甘肃省兰州市,甘肃中医药大学第一临床医学院
    2730050 甘肃省兰州市,中国人民解放军联勤保障部队第九四〇医院普外科
    3730070 甘肃省兰州市,甘肃省中心医院普外科
  • 通讯作者: 韩晓鹏
  • 作者简介:
    卢顺利,于建平,李洪涛,等.分化型甲状腺癌患者行甲状腺癌根治术后发生甲状旁腺功能减退的影响因素研究[J]. 中国全科医学,2022,25(23):2869-2873. [www.chinagp.net] 作者贡献:卢顺利、韩晓鹏提出研究思路、设计研究方案、数据解读、撰写论文及论文修订;卢顺利、李安东、陈超、何清远负责数据收集及统计学分析;于建平、李洪涛、陈为凯、韩晓鹏负责文章的质量控制及审校、监督管理。
  • 基金资助:
    甘肃省自然科学基金资助项目(20JR5RA599,21JR11RA172); 甘肃省卫生健康行业科研项目(GSWSKY2021-015); 甘肃省青年科技基金计划(21JR7RA013)

Abstract:

Background

Hypoparathyroidism is one of the common complications of radical thyroidectomy, but there are few studies on differentiated thyroid cancer.

Objective

To investigate the influencing factors of hypoparathyroidism in patients with differentiated thyroid carcinoma after radical thyroidectomy.

Methods

A total of 166 patients with differentiated thyroid carcinoma who underwent radical thyroidectomy from 940 Hospital of PLA Joint Logistics Support Force from June 2018 to December 2020 were included, and their clinical data were collected, including gender, age, body mass index (BMI), tumor site, tumor size, blood supply of lesion, whether there is capsule invasion, surgical method, scope of lymph node dissection, whether there is use of carbon nanoparticles, parathyroid gland resection. Also, this study monitors preoperative and postoperative serum PTH and follow-up monitoring levels of Ca2+.

Results

Among the 166 patients, the incidence of postoperative hypoparathyroidism was 28.31% (47/166), among which the incidence of temporary hypoparathyroidism was 21.68% (36/166) and the incidence of permanent hypoparathyroidism was 6.63% (11/166). There were statistically significant differences between patients with normal parathyroid function and patients with hypoparathyroidism in gender, age, tumor location, membranous invasion, surgical method, lymph node dissection and the use of carbon nanotube (P<0.05). The results of multivariate Logistic regression analysis showed that advanced age〔OR=1.042, 95%CI (1.003, 1.083) 〕, membranous invasion〔OR=2.825, 95%CI (1.198, 6.659) 〕 were risk factors for hypoparathyroidism in patients with differentiated thyroid carcinoma after radical thyroidectomy (P<0.05), Da Vinci robotic surgery〔OR=0.278, 95%CI (0.089, 0.868) 〕 and use of carbon nanoscale〔OR=0.374, 95%CI (0.144, 0.970) 〕 were protective factors for hypoparathyroidism in patients with differentiated thyroid carcinoma after radical thyroidectomy (P<0.05) .

Conclusion

Aging and capsular invasion are risk factors for hypoparathyroidism in patients with differentiated thyroid carcinoma after radical thyroidectomy. Da Vinci robotic surgery and the use of carbon nanoparticles can help reduce the risk of postoperative hypoparathyroidism.

Key words: Differentiated thyroid carcinoma, Hypoparathyroidism, Radical thyroidectomy, Risk factors, Root cause analysis, Retrospective studies

摘要:

背景

甲状旁腺功能减退是甲状腺癌根治术常见的并发症之一,尤其目前对于分化型甲状腺癌研究较少。

目的

探讨分化型甲状腺癌患者行甲状腺癌根治术后发生甲状旁腺功能减退的影响因素。

方法

回顾性选取2018年6月至2020年12月在中国人民解放军联勤保障部队第九四〇医院行甲状腺癌根治术的分化型甲状腺癌患者166例,收集患者的临床资料,包括性别、年龄、体质指数(BMI)、肿瘤部位、肿瘤大小、病灶血供、有无被膜侵犯、手术方式、淋巴结清扫范围、是否使用纳米碳、是否甲状旁腺误切、术前和术后血清甲状旁腺激素(PTH)及血钙水平。

结果

166例患者中,术后甲状旁腺功能减退发生率为28.31%(47/166),其中暂时性甲状旁腺功能减退发生率为21.68%(36/166),永久性甲状旁腺功能减退发生率为6.63%(11/166)。甲状旁腺功能正常和甲状旁腺功能减退者性别、年龄、肿瘤部位、有无被膜侵犯、手术方式、淋巴结清扫范围、是否使用纳米碳比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高龄〔OR=1.042,95%CI(1.003,1.083)〕、有被膜侵犯〔OR=2.825,95%CI(1.198,6.659)〕是分化型甲状腺癌患者行甲状腺癌根治术后发生甲状旁腺功能减退的危险因素(P<0.05),达芬奇机器人手术方式〔OR=0.278,95%CI(0.089,0.868)〕、使用纳米碳〔OR=0.374,95%CI(0.144,0.970)〕是分化型甲状腺癌患者行甲状腺癌根治术后发生甲状旁腺功能减退的保护因素(P<0.05)。

结论

年龄的增长以及被膜侵犯是分化型甲状腺癌患者行甲状腺癌根治术后发生甲状旁腺功能减退的危险因素,达芬奇机器人手术方式、使用纳米碳有助于降低术后发生甲状旁腺功能减退的风险。

关键词: 分化型甲状腺癌, 甲状旁腺功能减退, 甲状腺癌根治术, 危险因素, 影响因素分析, 回顾性研究