甲状腺手术中甲状旁腺显露及功能保护的临床研究
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摘要
目的探讨甲状腺手术中甲状旁腺显露及功能保护的临床研究。方法回顾分析2018年1月～2019年1月在天津第三中心医院行甲状腺切除术的54例患者临床资料,术中充分显露甲状旁腺,并保护显露的甲状旁腺和相关血供,观察术后甲状旁腺的功能状态。结果 54例患者术中50例患者甲状旁腺及血管充分显露,4例未清晰显露,未显露率为7.41%;术后15例发生低钙血症,发生率为27.77%。5例发生甲状旁腺功能降低,发生率为9.25%。治疗15 d后均恢复正常,未出现永久低钙血症。结论甲状旁腺位置与血供联系紧密,甲状腺切除术中应仔细解剖,并做好原位功能保护,可以有效避免术后甲状腺功能异常的发生,确保良好的手术效果,具有临床应用的重要价值。
Objective To investigate the clinical study of parathyroid exposure and functional protection in thyroid surgery.Methods Retrospective analysis of 54 patients with thyroidectomy in Tianjin Third Central Hospital from January 2018 to January 2019. The parathyroid glands were fully exposed and the exposed parathyroid glands and related blood supply were protected. Functional status of the posterior parathyroid glands. Results In54 patients, 50 cases of parathyroid gland and blood vessels were fully exposed, 4 cases were not clearly revealed, and the rate of non-obscuration was7.41%. In 15 cases, hypocalcemia occurred, the incidence rate was 27.77%. 5 patients developed hypoparathyroidism with an incidence of 9.25%.After 15 d of treatment, they returned to normal and no permanent hypocalcemia occurred.Conclusion The position of the parathyroid gland is closely related to blood supply. It should be carefully dissected during thyroidectomy and protected by in situ function. It can effectively prevent the occurrence of postoperative thyroid dysfunction and ensure good surgical results. It has important value for clinical application.
Objective To investigate the clinical study of parathyroid exposure and functional protection in thyroid surgery.Methods Retrospective analysis of 54 patients with thyroidectomy in Tianjin Third Central Hospital from January 2018 to January 2019. The parathyroid glands were fully exposed and the exposed parathyroid glands and related blood supply were protected. Functional status of the posterior parathyroid glands. Results In54 patients, 50 cases of parathyroid gland and blood vessels were fully exposed, 4 cases were not clearly revealed, and the rate of non-obscuration was7.41%. In 15 cases, hypocalcemia occurred, the incidence rate was 27.77%. 5 patients developed hypoparathyroidism with an incidence of 9.25%.After 15 d of treatment, they returned to normal and no permanent hypocalcemia occurred.Conclusion The position of the parathyroid gland is closely related to blood supply. It should be carefully dissected during thyroidectomy and protected by in situ function. It can effectively prevent the occurrence of postoperative thyroid dysfunction and ensure good surgical results. It has important value for clinical application.
引文
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[5]包晓都,张筱骅,李忠朋,等.Focus超声刀在甲状腺手术中对甲状旁腺功能的保护作用评价[J].中国普通外科杂志,2015,24(9):1295-1298.
[6]廖泉.甲状腺外科手术中甲状旁腺功能保护[J].中国实用外科杂志,2015,35(6):672-673.
[2]张滨,连凌云,李小毅,等.甲状腺手术中甲状旁腺损伤原因分析及功能保护[J].陕西医学杂志,2013,42(3):334-336.
[3]徐兴亮.甲状腺手术中甲状旁腺显露及功能保护的临床研究[J].医学信息,2015,28(z2):237
[4]徐德全,代文杰.甲状旁腺激素替代疗法治疗甲状旁腺功能减退研究进展[J].中国实用外科杂志,2014,34(5):459-461.
[5]包晓都,张筱骅,李忠朋,等.Focus超声刀在甲状腺手术中对甲状旁腺功能的保护作用评价[J].中国普通外科杂志,2015,24(9):1295-1298.
[6]廖泉.甲状腺外科手术中甲状旁腺功能保护[J].中国实用外科杂志,2015,35(6):672-673.