Clinical Study On The Function Protection Of Parathyroid Grand In Thyroidectomy

Objective：Thyroid nodules is the common and frequently-occurring diseasein endocrine system. In recent years, thyroidectomy has been generallycarried out in clinical surgery, this research is to analyse Parathyroid functionin thyroidectomy used the operation methods of cluster high ligation in upperand lower thyroid and the refinement anatomy, to explore the significance ofthe protection function in the refinement anatomy of parathyroid glands.Methods：Random, single blind comparison used in this study. Selected from2012January to2014January452patients underwent thyroidectomy in ourhospital. The serum calcium and PTH were detected before the operationand the first day after operation. According to the operation method,they weredivided into conventional group (group A213) and the improved group (Bgroup239), each group according to the character of tumour divided asbenign group (A1108、B194) and the malignant group (A2105、B2145).Group A included213patients treated by the traditional operation of thyroidgland lobectomy, exposed the thyroid gland and then cluster high ligation inupper and lower thyroid, no routine exposure and protection of parathyroid inthe surgery. Group B included239patients of thyroid was according to theoperation principle of in situ protection of parathyroid by the refinementanatomy. to avoid cluster ligation and electric knife scalding, pay attention toprotect the micro vascular in the parathyroid adhesion side, in order toachieve the purpose that "in situ conservation" parathyroid. Results: Postoperative serum calcium and PTH were significantly decreasedbetween A and B group compared with preoperative analysis (P<0.05), thedifference has statistical significance; Compared the preoperative serum PTHand serum calcium with postoperative,the results of decreased amplitude forPTH and calcium compared between groups were that: A group>B group, A1group>B1group, A2group>B2group, the difference was statisticallysignificant (P<0.05). To compare the postoperative incidence of adversereactions (hypocalcemia, hypoparathyroidism, symptomatic hypocalcemia):there was significant difference between A and B group (P<0.05);there wassignificant difference for the incidence of adverse reactions(hypoparathyroidism, hypocalcemia, symptomatic hypocalcemia) between A1and B1group (P<0.05); the rate of postoperative hypoparathyroidismoccurred had significant difference between A2and B2group (P<0.05), therate of hypocalcemia and symptomatic hypocalcemia incidence had nosignificant difference (P>0.05).Conclusion: Compared to the cluster high ligation in upper and lower thyroidin thyroidectomy，closed to the membrane surface and parathyroid gland insitu conservation for the operation reduce the rate of postoperativehypoparathyroidism occurred evidently which is worth of the clinicalpromotion.