甲状腺癌手术中甲状旁腺损伤的发生情况以及相关危险因素分析
|
摘要
目的分析甲状腺癌手术中甲状旁腺损伤的发生情况,并对相关危险因素进行分析。方法选取确诊并接受手术治疗的甲状腺癌患者75例纳入研究。收集患者基本信息,并对潜在影响手术效果的各种因素进行调查。术后统计甲状旁腺损伤的发生率以及潜在影响因素作用情况。结果研究中纳入男性患者10例,女性患者65例;平均年龄(44. 09±4. 52)岁,年龄≥45岁患者比例为62. 67%; AJCC分期Ⅰ～Ⅳa期患者比例分别为73. 33%、12. 00%、9. 33%和5. 33%;性别年龄分布以及甲状腺癌的AJCC分期两性间差别未见统计学意义,P> 0. 05;单侧与双侧肿瘤的分布比例分别为78. 67%和21. 33%;患者术中接受了单侧淋巴结清扫术者占50. 67%。男性与女性之间的分布差异也均未见统计学意义。甲状旁腺损伤的发生率为12. 00%,其中男性为20. 00%,女性为10. 77%;两性之间差别未见统计学意义,P>0. 05;其中年龄≥45岁者的甲状旁腺损伤发生率为10. 67%,高于年龄<45岁者水平(1. 33%);男性内部也见年龄≥45岁者更高,且差别均有统计学意义,均有P <0. 05;损伤原因来自于钳夹挫伤、血供障碍以及误切等。借助回归模型对潜在影响甲状旁腺损伤的因素进行多因素分析,结果提示,男性、年龄≥45岁、AJCC分期高以及双侧肿瘤患者发生甲状旁腺损伤的风险更高,OR值分别为2. 205、3. 253、2. 333以及3. 159。结论甲状腺癌手术中甲状旁腺损伤的发生率在9. 77%,其中男性患者、年龄≥45岁、AJCC分期高以及双侧肿瘤患者发生甲状旁腺损伤的风险更高。
Objective To analyze the incidence of parathyroid injury in thyroid cancer surgery and the related risk factors. Methods A total of 75 patients with thyroid cancer diagnosed and undergoing surgical treatment were included in the study. Collect basic information of the patients and investigate factors that may affect the surgical outcome. The incidence of parathyroid injury and the effect of potential influencing factors were calculated after surgery. Results The study included 10 male patients and 65 female patients; the average age was( 44. 09 ± 4. 52) years old; the proportion of patients aged ≥45 years was62. 67%; the proportion of patients with AJCC staging I-IVa was 73. 33%,12. 00%,9. 33%,and 5. 33%,respectively.; distribution and thyroid cancer AJCC staging showed no statistical significance between the genders,P > 0. 05; unilateral and bilateral tumors were 78. 67% and 21. 33%; In patients undergoing unilateral lymphadenectomy,50. 67% were performed. Differences in distribution between men and women were also without statistically significance. The incidence of parathyroid injury was 12. 00%,20. 00% in males and 10. 77% in females. There was no statistically difference between genders,P > 0. 05; among females,the incidence of parathyroid injury which ≥45 years old was 10. 67%,higher than the ones < 45 years old( 1. 33%); similar trend was detected among males,all P < 0. 05. A multivariate analysis of factors showed that potential factors thataffected parathyroid gland injury included male gender,age ≥45 years,higher AJCC staging,and bilateral tumors had a higher risk of parathyroid injury,with an OR of 2. 205,3. 253,2. 333,and 3. 159. Conclusion The incidence of parathyroid injury in thyroid cancer surgery is9. 77%. Male patients,age≥45 years,high AJCC stage,and bilateral tumor patients have a higher risk of parathyroid injury.
Objective To analyze the incidence of parathyroid injury in thyroid cancer surgery and the related risk factors. Methods A total of 75 patients with thyroid cancer diagnosed and undergoing surgical treatment were included in the study. Collect basic information of the patients and investigate factors that may affect the surgical outcome. The incidence of parathyroid injury and the effect of potential influencing factors were calculated after surgery. Results The study included 10 male patients and 65 female patients; the average age was( 44. 09 ± 4. 52) years old; the proportion of patients aged ≥45 years was62. 67%; the proportion of patients with AJCC staging I-IVa was 73. 33%,12. 00%,9. 33%,and 5. 33%,respectively.; distribution and thyroid cancer AJCC staging showed no statistical significance between the genders,P > 0. 05; unilateral and bilateral tumors were 78. 67% and 21. 33%; In patients undergoing unilateral lymphadenectomy,50. 67% were performed. Differences in distribution between men and women were also without statistically significance. The incidence of parathyroid injury was 12. 00%,20. 00% in males and 10. 77% in females. There was no statistically difference between genders,P > 0. 05; among females,the incidence of parathyroid injury which ≥45 years old was 10. 67%,higher than the ones < 45 years old( 1. 33%); similar trend was detected among males,all P < 0. 05. A multivariate analysis of factors showed that potential factors thataffected parathyroid gland injury included male gender,age ≥45 years,higher AJCC staging,and bilateral tumors had a higher risk of parathyroid injury,with an OR of 2. 205,3. 253,2. 333,and 3. 159. Conclusion The incidence of parathyroid injury in thyroid cancer surgery is9. 77%. Male patients,age≥45 years,high AJCC stage,and bilateral tumor patients have a higher risk of parathyroid injury.
引文
[1]吕春晖,陈海珍,沈晓卉,等.甲状腺全切除术后甲状旁腺功能减退的相关危险因素分析[J].中华普通外科杂志,2017,32(10):104-106.
[2]乐飞,游小龙,陈雯,等.小切口腔镜辅助甲状腺切除术治疗分化型甲状腺癌的疗效观察[J].实用癌症杂志,2018,33(2):227-229.
[3]卜玲,牟笑,郑婷婷,等.EGCG对甲状腺癌细胞增殖和摄碘能力的影响[J].江苏大学学报(医学版),2017,27(1):10-13.
[4]曹龄之,杨凡慧,温琥玲,等.Annexin-Ⅱ及VEGF-C在甲状腺乳头状癌中的表达及其意义[J].标记免疫分析与临床,2017,24(5):542-544.
[5]王娴,谌业荣,张国梁,等.磁共振弥散加权成像评估甲状腺乳头状癌恶性分级的临床价值[J].江苏大学学报(医学版),2018,21(1):258-261.
[6]王兴,朱一鸣,黄辉,等.甲状腺癌术中甲状旁腺误切危险因素分析[J].中国实用外科杂志,2017,37(9):1028-1031.
[7]陈敏,雷勇,黄铁军.甲状腺癌术后131I治疗对甲状旁腺功能的影响[J].医学检验与临床,2015,21(2):18-19.
[8]崔勇,孙茂伟,赵东旭.甲状腺全切除术在分化型甲状腺癌外科治疗中的应用价值[J].实用癌症杂志,2017,32(7):1214-1215.
[9]张群,李多杰.原发性甲状腺鳞状细胞癌2例病例报道并文献复习[J].实用肿瘤学杂志,2017,31(2):156-159.
[10]赵宁,滕长胜.甲状腺癌手术中甲状旁腺的识别和保护[J].国际外科学杂志,2015,42(2):114-116.
[11]谢珊珊,高友兵,吴丽媛.甲状腺癌不同手术方式对甲状旁腺功能的影响[J].华南国防医学杂志,2017,15(6):390-393.
[2]乐飞,游小龙,陈雯,等.小切口腔镜辅助甲状腺切除术治疗分化型甲状腺癌的疗效观察[J].实用癌症杂志,2018,33(2):227-229.
[3]卜玲,牟笑,郑婷婷,等.EGCG对甲状腺癌细胞增殖和摄碘能力的影响[J].江苏大学学报(医学版),2017,27(1):10-13.
[4]曹龄之,杨凡慧,温琥玲,等.Annexin-Ⅱ及VEGF-C在甲状腺乳头状癌中的表达及其意义[J].标记免疫分析与临床,2017,24(5):542-544.
[5]王娴,谌业荣,张国梁,等.磁共振弥散加权成像评估甲状腺乳头状癌恶性分级的临床价值[J].江苏大学学报(医学版),2018,21(1):258-261.
[6]王兴,朱一鸣,黄辉,等.甲状腺癌术中甲状旁腺误切危险因素分析[J].中国实用外科杂志,2017,37(9):1028-1031.
[7]陈敏,雷勇,黄铁军.甲状腺癌术后131I治疗对甲状旁腺功能的影响[J].医学检验与临床,2015,21(2):18-19.
[8]崔勇,孙茂伟,赵东旭.甲状腺全切除术在分化型甲状腺癌外科治疗中的应用价值[J].实用癌症杂志,2017,32(7):1214-1215.
[9]张群,李多杰.原发性甲状腺鳞状细胞癌2例病例报道并文献复习[J].实用肿瘤学杂志,2017,31(2):156-159.
[10]赵宁,滕长胜.甲状腺癌手术中甲状旁腺的识别和保护[J].国际外科学杂志,2015,42(2):114-116.
[11]谢珊珊,高友兵,吴丽媛.甲状腺癌不同手术方式对甲状旁腺功能的影响[J].华南国防医学杂志,2017,15(6):390-393.