PDF(Pubmed)
Abstract：
To study the incidence and management of postoperative hypocalcemia in participants undergoing near-total (NTT) and total thyroidectomy (TT) at a tertiary health care center. This is an observational prospective study. Patients posted for NTT and TT in our institute and meeting the inclusion criteria were included. A total of 45 participants were enrolled. The serum calcium was measured on postoperative day 2, at the time of discharge and on 3 months follow-up. A combination of injectable and oral calcium supplements with or without vitamin D sachet was used for the treatment of hypocalcemia. Hypocalcemia was observed in 49% cases. Women were observed to develop hypocalcemia at a higher rate than men. Incidence of hypocalcemia was more in TT patients than NTT patients. Cases with malignant pathology were more susceptible to develop hypocalcemia than those with benign pathology. Operated TT with concomitant neck dissection were at higher risk for development of hypocalcemia. There was no significant association between age and incidence of hypocalcemia. Serum calcium measured on postoperative day 2 was a reliable indicator of risk of hypocalcemia. The early measurement of serum calcium level is a reliable indicator of the risk of hypocalcemia. Standardized treatment of hypocalcemic patients with calcium and vitamin D supplements can reduce the incidence and morbidity associated with postoperative hypocalcemia.
摘要：
研究在三级卫生保健中心接受近全甲状腺（NTT）和全甲状腺切除术（TT）的参与者术后低钙血症的发生率和管理。这是一项观察性前瞻性研究。纳入了在我们研究所张贴NTT和TT并符合纳入标准的患者。共招募了45名参与者。在术后第2天，出院时和随访3个月时测量血清钙。可注射和口服钙补充剂（含或不含维生素D小袋）的组合用于治疗低钙血症。在49％的病例中观察到低钙血症。观察到女性发生低钙血症的比率高于男性。TT患者的低钙血症发生率高于NTT患者。恶性病理的病例比良性病理的病例更容易发生低钙血症。手术TT合并颈淋巴结清扫术发生低钙血症的风险较高。年龄和低钙血症发生率之间没有显著关联。术后第2天测量的血清钙是低钙血症风险的可靠指标。早期测量血清钙水平是低钙血症风险的可靠指标。补充钙和维生素D的低钙血症患者的规范化治疗可以降低术后低钙血症的发生率和发病率。
