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| 甲状腺癌根治术中甲状旁腺自体移植的临床疗效分析 |
| Clinical efficacy of auto-transplantation of parathyroid gland during thyroid cancer radical surgery |
| 投稿时间：2014-09-15 修订日期：2015-01-10 |
| DOI：10.3969/j.issn.1000-0399.2015.05.029 |
| 中文关键词: 甲状旁腺 甲状腺切除术 自体移植 甲状腺癌 |
| 英文关键词: Parathyroid gland Thyroidectomy Autotransplantation Thyroid cancer |
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| 中文摘要: |
| 目的 探讨甲状腺癌根治术中应用甲状旁腺自体移植(PAT)的临床疗效。方法 选择2009年1月至2014年1月在我院行甲状腺癌根治术的患者141例,按照术中是否接受PAT分为两组。观察组63例,为接受PAT患者;对照组78例,为未接受PAT患者。比较两组术后1、2、3和7 天的临床症状及体征、记录术后永久性及暂时性甲状旁腺功能低下(HP)的发生率,并与对两组术后甲状旁腺激素(PTH)水平进行比较。结果 术后1、2、3和7天,观察组术后PTH低下的症状主要以感觉异常、肢端麻木等轻度症状为主,重症如腕-足痉挛、面神经征、陶瑟征及焦虑较少,术后各种症状发生率明显低于对照组(P<0.05);观察组术后永久性HP发生率明显低于对照组(χ2=5.95,P<0.05);暂时性HP的发生率亦明显低于对照组(χ2=10.02,P<0.05);观察组术后2、3、4、12和24周的PTH水平明显高于对照组(P<0.05)。结论 甲状腺癌根治术中应用PAT疗效显著,能够减轻患者术后的PTH低下的不良症状,且对术后HP的发生起到重要的预防作用。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy of auto-transplantation of parathyroid gland during thyroid cancer radical surgery. Methods A total of 141 cases of patients underwent thyroid cancer radical surgery in our hospital from January 2009 to January 2014 were divided into two groups according to whether auto-transplantation of parathyroid gland was performed or not: namely the PAT group (observation group, n=63 cases) and non- PAT group (control group, n=78 cases); clinical symptoms and physical signs of two groups were compared on postoperative 1d, 2d, 3d and 7d; incidences of permanent and temporary HP were recorded after surgery, and postoperative parathyroid hormone (PTH) levels were also compared. Results On postoperative 1d, 2d, 3d and 7d, low PTH symptoms of observation group were mainly mild symptoms including paresthesia and extremities numbness; less severe symptoms such as wrist-foot cramps, symptoms of facial nerve, trousseau sign and anxiety were found, and incidences of postoperative symptoms were significantly lower than those in control group (P<0.05); incidence of postoperative permanent HP in observation group was obviously lower than that in control group (χ2=5.945, P<0.05), and incidence of temporary HP was also significantly lower than that of the control group (χ2=10.023, P<0.05); PTH levels of observation group were significantly higher than those of control group after postoperative 2 weeks, 3 weeks, 4 weeks, 12 weeks and 24 weeks (P<0.05). Conclusion The curative effect of auto-transplantation of parathyroid gland during radical surgery is distinct, and it can appropriately reduce patients' postoperative adverse symptoms of low PTH level, playing an important role in prevention of the occurrence of postoperative HP. |
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