Objective To investigate the changes and influencing factors of thyroid function six months after unilateral lobectomy for benign thyroid nodules.Methods Clinical data of 97 patients who underwent unilateral thyroid lobotomy from October 2017 to June 2019 were analyzed.All subjects were randomly divided into young and middle-aged group(< 55 years old)(n = 64)and elderly group(≥55 years old)(n = 33)according to their admission information.The patients were divided into normal thyroid group(62 cases)and hypothyroidism group(35 cases)according to the postoperative thyroid function.Free triiodothyronine(FT3),free thyroxine(FT4)and thyrotropin(TSH)were detected before surgery and 2 and 6 months after surgery,respectively.(1)Compare and analyze the changes of thyroid function before and after the operation in the young and middle-aged group and the old group.(2)Analyze the risk factors for hypothyroidism after surgery,including the patient’s age,gender,postoperative TSH level,and postoperative thyroid nodules pathological type.SPSS 23.0 software was used for statistical analysis of data among all groups.Measurement data were expressed as mean ± standard deviation.Independent sample t test was used to compare the differences in the level of measurement indicators among all groups.P <0.05 indicates that the difference is statistically significant;The statistical data were χ2 test,P <0.05 indicates that the difference is statistically significant.Results(1)The comparison of thyroid function before and after the operation between the young and middle-aged group and the old group showed that: FT3: There is no significant difference between the young and middle-aged group and the old group before the operation(FT3=4.58±0.55 pmol/L in the young and middle-aged group,FT3=4.35±0.72 pmol/L in the old group),there is no statistically significant difference between the two groups(P >0.05)2 months after the operation,there was no significant difference between the young and middle-aged group and the old group(the young and middle-aged group was 4.28±0.62 pmol/L,the old group FT3=4.17±0.66 pmol/L),the difference between the two groups was not statistically significant(P >0.05 6 months after the operation,the young and middle-aged group was higher than that of the old group(the young and middle-aged group was 4.41±0.70 pmol/L,the old group FT3=4.12±0.57 pmol/L),the difference was statistically significant(P <0.05).FT4: There was no significant difference between the young and middle-aged group and the old group before the operation(FT4=16.10±2.26pmol/L in the young and middle-aged group,FT4=15.88±2.35 pmol/L in the old group),there was no statistically significant difference between the two groups(P >0.05)2 months after the operation,the young and middle-aged group was higher than the old group(FT4=15.99±1.81 pmol/L in the young and middle-aged group,FT4=15.58±2.01 pmol/L in the old group),and the difference was statistically significant(P<0.05);In the last 6 months,the young and middle-aged group was significantly higher than the old group(FT4=15.81 ± 1.73 pmol/L in the young and middle-aged group,FT4=15.30±1.66 pmol/L in the old group),and the difference was statistically significant(P <0.05).TSH: The preoperative young and middle-aged group was lower than the old group(TSH=2.25±1.79 u IU/m L in the young and middle-aged group,TSH=2.56±1.22 u IU/m L in the old group),the difference was statistically significant(P < 0.05);2 The young and middle-aged group was lower than the old group(TSH=4.47±1.11 u IU/m L in the young and middle-aged group,TSH=4.83±1.52 u IU/m L in the old group),the difference was statistically significant(P<0.05);6 months after the operation The young and middle-aged group was lower than the old group(TSH=3.25±1.06 u IU/m L in the young and middle-aged group,TSH=3.72±1.53 u IU/m L in the old group),and the difference was statistically significant(P <0.05).(2)The univariate analysis of hypothyroidism after surgery showed that: Gender: Compared with the hypothyroidism group,there were 10 males(10.3%)and 52 females(53.7%)in the normal thyroid group.In the hypothyroidism group,there were 11 males(11.3%)and 24 females(24.7%).There was no significant correlation between the gender of patients and postoperative hypothyroidism,and the difference was not statistically significant(P>0.05).Pathological types: Compared with the hypothyroidism group,there was no significant correlation between the pathological types of thyroid nodules and postoperative hypothyroidism in the normal thyroid function group and the hypothyroidism group,and the difference was not statistically significant(P > 0.05).Age: Compared with hypothyroidism group,51 patients(52.6%)and 11 patients(11.3%)in normal thyroid group were middle-aged and young,and 11 patients(11.3%).In the hypothyroidism group,25 were young and middle-aged(25.8%)and 10 were elderly(10.3%).The age of patients was significantly correlated with postoperative hypothyroidism,and the possibility of developing postoperative hypothyroidism in young and middle-aged patients was significantly lower than that in elderly patients,with statistical significance(P < 0.05).High preoperative TSH level: Compared with the hypothyroidism group,43 patients(44.3%)had lower preoperative TSH level and 19 patients(19.6%)had higher preoperative TSH level in the normal thyroid group.In the hypothyroidism group,preoperative TSH level was low in 10 patients(10.3%)and high in 25 patients(25.8%).High preoperative TSH level of patients was closely related to the occurrence of postoperative hypothyroidism.Patients with higher preoperative TSH level had a higher possibility of postoperative hypothyroidism than those with lower preoperative TSH level,with statistical significance(P < 0.05).Conclusion Hypothyroidism is an important complication after unilateral thyroidectomy,and the incidence is about 36.1%.Different populations have different changes in thyroid function six months after unilateral lobectomy.Elderly patients and high preoperative TSH levels may be risk factors for hypothyroidism,and have certain predictive value for postoperative thyroid function to return to normal. |