The Analysis And Countermeasures Of Hypoparathyroidism After Total Thyroidectomy

Objective: To investigate the reasons of hypoparathyroidism andhypocalcemia reasons (PHC) in the prevention and treatment after totalthyroidectomy。Methods: Data of289cases of total thyroidectomy treated fromJanuary2011to January2013were retrospectively reviewed．Analysisof clinical features and treatment methods。43cases are male, female246cases, male to female ratio：1:5.72。Detecting PTH sCa beforetheir operation。Parathyroid is not routinely exposed during surgery，Review PTH、 Ca after their surgery， and with their clinicalmanifestations，To investigate the reasons of hypoparathyroidism andhypocalcemia reasons (PHC) in the prevention and treatment after totalthyroidectomy。Results:1、After total thyroidectomy surgery,PTH and serum Caions decreased significantly compared with the preoperative,and reachedthe lowest point at the second day; During the first5days, PTH andserum Ca resume will be at normal range in80%of patients of,15daysafter95%of patients can be fully restored;2、289cases of surgicalpatients, the occurrence of hypocalcemia in patients with176cases,accounting for60.90%, it is a higher incidence;3、The incidence ofhypocalcemia positively correlated with the extent of surgery, that with the increase in thyroid surgery to expand the scope and difficulty ofoperation, the possibility of postoperative hypocalcemia greater; Withthe expansion of the scope of the surgery, the serum Ca ion levels weresignificantly lower on average, and the recovery is slower than thesmaller;4、PTH positively correlated with changes in Ca changes thataffect thyroid surgery postoperative PTH secretion of parathyroidfunction leading to inadequate postoperative PTH secretion lead tohypocalcemia.Conclusion:1、It is a high incidence of hypocalcemia after total thyroidectomy;2、The probability of hypoparathyroidism and hypocalcemia aftertotal thyroidectomy is related to extent of surgery: with the greater ofthe extent of surgery, more likely of hypoparathyroidism andhypocalcemia will appear;3、 Recovery time of parathyroid function and serum calcium levelsare negatively correlated with the extent of surgery after totalthyroidectomy is related to extent of surgery：the greater of the extentof surgery，the longer recovery time of parathyroid function and serumcalcium levels；4、The probability of hypoparathyroidism and hypocalcemia aftertotal thyroidectomy has nothing to do with gender and age； 5、PTH and Ca changes are positively correlated after totalthyroidectomy.