Analysis of risk factors for hypoparathyroidism in patients after thyroidectomy

doi:10.16139/j.1007-9610.2020.06.013

Abstract

Abstract:

Objective To analyze the risk factors associated with hypoparathyroidism (HP) after thyroidectomy. Methods The clinical data of 118 patients with thyroidectomy were reviewed in Ruijin Hospital including parathyroid hormone (PTH) in serum before and after surgery from May 2018 to July 2018. Risk factors associated with postoperative HP were analyzed by multivariate Logistic regression models. Results The incidence of postoperative HP in this study was 17.80% including 2 cases with permanent HP. PTH in serum of 2 cases with permanent HP was 0.049 6 pg/L, 0.008 2 pg/L, 0.013 8 pg/L and those of 19 cases with temporary HP was 0.047 9 pg/L, 0.021 7 pg/L, 0.033 2 pg/L preoperative, postoperative 1 d and 180 d later respectively. Univariate analysis showed that HP was related with tumor N₁ stage, Hashimoto thyroiditis, lymph node dissection, parathyroidectomy, without use of nano-carbon tracer and tumor diameter (P<0.05). However, HP was not related with gender, age, body mass index, hypertension, smoking, drinking, and pathological type (P>0.05). It was shown by multivariate analysis that Hashimoto thyroiditis, tumor N₁ stage, tumor diameter 4 cm and more, lymph node dissection, parathyroidectomy, without use of nano-carbon tracer were independent risk factors for HP. Conclusions The patients with HP after total thyroidectomy were associated with tumor N₁ stage, Hashimoto thyroiditis, tumor diameter 4 cm and more, lymphatic dissection, parathyroidectomy, and without use of nano-carbon tracer which would be the risk factors of HP.

Key words: Thyroidectomy, Hypoparathyroidism, Risk factor

CLC Number:

R653

GUO Ying, XU Huijie, ZHENG Lei, ZHANG Shiyu, LEI Ming, YAN Jiqi, CHEN Xi, YANG Weiping. Analysis of risk factors for hypoparathyroidism in patients after thyroidectomy[J]. Journal of Surgery Concepts & Practice, 2020, 25(06): 507-511.

Figures/Tables 3

References 21

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临床资料		正常（n=97）	减退（n=21）	P值
年龄（岁）		49.69±8.95	49.45±9.84	>0.05
性别	男女	27（27.84） 70（72.16）	6（28.57） 15（71.43）	>0.05
BMI		22.03±3.23	22.95±3.03	>0.05
合并高血压		15（15.46）	3（14.28）	>0.05
合并桥本甲状腺炎		2（2.06）	6（28.57）	<0.05
吸烟		19（19.59）	5（23.81）	>0.05
饮酒		7（7.22）	3（14.28）	>0.05
淋巴结清扫		39（40.2）	19（90.48）	<0.05
甲状旁腺误切		0	2（9.52）	<0.05
病理类型	良性恶性	26（26.80） 71（73.20）	0 21（100.00）	>0.05
肿瘤N分期	N₀ N₁	13（13.40） 58（59.80）	0 21（100.00）	<0.05
未应用纳米炭示踪剂		43（44.33）	19（90.48）	<0.05
肿瘤直径(cm)		2.48±1.25	4.86±1.47	<0.05

因素	标准误（SE）	回归系数（β）	卡方值(Wald)	P值	比数比（OR）	95%CI
合并桥本甲状腺炎	0.331	0.691	4.358	0.037	1.996	1.043~3.818
肿瘤N₁分期	0.284	0.658	5.281	0.026	2.443	1.127~3.759
淋巴结清扫	0.213	0.552	6.716	0.010	1.737	1.144~2.637
甲状旁腺误切	0.187	0.433	5.362	0.021	1.542	1.069~2.224
肿瘤直径≥4 cm	0.432	1.087	6.331	0.012	2.965	1.272~6.915
未应用纳米炭示踪剂	0.215	0.664	9.538	0.002	1.943	1.275~2.961

指标	组别	例数	术前	术后1 d	术后180 d	P值
PTH（pg/L）	永久性	2	0.049 6±0.014 9	0.008 2±0.009 5	0.013 8±0.015 9	<0.001
	暂时性	19	0.047 9±0.017 2	0.021 7±0.009 7	0.033 2±0.016 7
血钙（mmol/L）	永久性	2	2.32±0.18	1.12±0.19	1.75±0.12	<0.001
	暂时性	19	2.29±0.12	1.91±0.13	2.30±0.23