Clinical Investigation Of Secrum Calcium After Resection Of Thyroid Cancer

Objective Study of the dynamic changes of serum calcium after resection of thyroid cancer. Through summarizing the rule of the postoperative serum calcium dynamic change and the incidence of the hypocalcemia. Explore the causes and mechanism of postoperative hypocalcemia.Summary the prevention and treatments of the hypocalcemia.Methods 787 cases thyroid carcinoma patients from January 2010 to ecember 2010 in our hospital were collected,228 cases multifocal cancer was iagnosed by pathology,8 cases was medullary thyroid carcinoma,1 case was medullary arcinoma associated with papillary carcinoma,1 case of squamous cell carcinoma,549 cases was Single focal papillary thyroid carcinoma. The ratio of Male to female was 1:3.8. Age range 17to79 years, mean 42.9 years old. Among them,237 cases received total thyroid resection(including 12 cases of secondary surgery),22 cases received unilateral total thyroidectomy of the affected lobe plus isthmic resection,352 cases received nilateral total thyroidectomy of the affected lobe plus subtotal thyroidectomy of the opposite lobe,151 cases received nilateral total thyroidectomy of the affected lobe plus nearly total thyroidectomy of the opposite lobe.24 cases received bilateral subtotal thyroidectomy by Isthmic carcinoma,1 patients received palliative resection thyroid carcinoma All patients underwent lymph node dissection.Result All the patients had no permanent hypoparathyroidism.262 cases had temporary hypoparathyroidism.119/237cases received total thyroid resection.143/549 cases received unilateral total thyroidectomy. The former higher than the latter. The incidence of unilateral total thyroidectomy of the affected lobe plus and bilateral subtotal thyroidectomy by isthmic resection was lowest. The incidence of total thyroid resection was highest.Absolutely, the more resection,the higher the incidence of hypocalcemia,and it was hard to rectify. It was different when gave the same calcium supplement between total thyroid resection and unilateral total thyroidectomy. The incidence of second surgery of total thyroid resection was higher than frist surgery of total thyroid resection.Conclution 1. Unilateral total thyroidectomy surgical resection, the more the opposite lobe resect,the higher the incidence of hypocalcemia, but below the total thyroid resection of thyroid cancer.2. Temporary hypocalcemia is a common complication after radical resection of thyroid cancer, the more the surgery resecting, postoperative hypocalcemia more difficult to correct.3. The hypocalcemia incidence of secondary total thyroid resection was higher than that of first total thyroid resection to thyroid surgery, ascribe to tissue adhesion which add the hardness to recognize the parathyroid and more likely to cause injury to parathyroid and the blood supply of it.4. The prevention of hypocalcemia,:frist you should familiar with the anatomy of parathyroid, secondly improving notonly the ability to identify parathyroid in surgery, butalso protecting the blood supply, monitoring of serum calcium after calcium dose adjustment and Seasonable compensatory calcium.