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1、中文摘要甲状腺癌全切术后甲状旁腺功能减退及血钙变化规律目的：探讨甲状腺癌行甲状腺全切除术后发生甲状旁腺功能减退以及低钙血症的原因、预防及治疗方法：回顾性分析吉林大学白求恩第二医院甲状腺外科2013年1月到2015年1月期间因甲状腺癌而行甲状腺全切除术的患者186例，其中男性44例，女性142例，男女比例约为1:3.23。记录每位患者术前1-2天、术后第1、2、5天的血清甲状旁腺素及钙离子水平，结合患者临床表现，分析术后甲状旁腺功能减退及低钙血症的原因、预防及治疗。结果：1、术后不同程度出现数值较术前下降，多数患者最低数值在术后第2天出现，绝大多数患者术后第5天临床症状消
2、失或较轻微。随访半年余，未发现永久性甲状旁腺功能减退患者出现。2、186例患者中，出现甲状旁腺功能减退和低钙血症患者约有60例，约占32.26%。甲状旁腺功能减退及低钙血症发生率较高。结论：1甲状腺癌全切除术后甲状旁腺功能减退及低钙血症发生率较高，且联合中央区淋巴结清扫术和侧颈淋巴结清扫术的患者术后发生I率较单纯行甲状腺全切术的患者发生率高；2防止术后发生甲状旁腺功能减退和低钙血症的关键在于甲状旁腺的术中保护，尤其是甲状旁腺的原位保护；3甲状腺全切除术后发生甲状旁腺功能减退和低钙血症的患者补充钙剂应遵循个体化原则。关键词：甲状腺全切除术，甲状旁腺，甲状旁功能减退，低钙血
3、症IIAbstractHypoparathyroidismandvariationruleofserumcalciumaftertotalthyroidectomyofthyroidcarcinomaObjective：Discussiononthecause,preventionandtreatmentofhypoparathyroidism(PTH)andpostthyroidectomyhypocalcemia-(PHC)aftertotalthyroidectomyofthyroidcarcinoma.Methods:Aretrospectiveanalysis
4、ofSecondHospitalofJilinUniversityfrom2013Januaryto2015Januaryinthyroidsurgeryforthyroidcarcinomaresectionin186patients,including44casesofmale,female142cases,maletofemaleratioisabout1:3.23.Recordtheserumparathyroidhormoneandcalciumlevelsofeverypatients,before1-2daysoftheiroperation,1,2,5d
5、aysaftertheiroperation,combinedwiththeclinicalmanifestations,toanalysethecauses,preventionandtreatmentofthehypoparathyroidismandpostthyroidectomyhypocalcemia.Results:1.Aftertotalthyroidectomy,PTHandserumcalciumdecreasedindifferentdegreecomparedwiththepreoperative,andthelowestnumericaloft
6、hemajorityofpatientsoccurredinthese-conddaysaftersurgery,andtheirclinicalsymptomsdisappearedorminorafterfifthdaysIIIinmostofthem.Followupformorethansixmonths,foundnopermanenthypoparathyroidismpatients.2.In186patients,hypoparathyroidismandhypocalcemiainpatientsabout60cases,accountingforab
7、out32.26%.Higherincidenceofhypoparathyroidismandhypokalemia.Conclusion:1.Aftertotalthyroidectomyofthyroidcarcinomahypoparathyroidismandhypocalcemiaoccurredatahigherrate,thehighincidenceofoccurrencerateincentrallymphnodedissectionandlateralneckdissectioncombinedwithonlythy
