Symptomatic Hypoparathyroidism After Thyroid Surgery Of Related Factor Clinical Analysis

Object:To confirm the related factor of hypoparathyroidism after thyroidsurgery(benign or malignant disease、initial surgery or reoperation、different surgicalmethods).Investigate the parathyroid protection in thyroid surgery.Methods:755cases of patients with thyroid surgery were selected from department ofBreast&Thyroid Surgery of Tongji hospital between January2008and December2009.Statistical analysis the occurrence of symptomatic hypocalcemia in differentpathological types、initial surgery or reoperation、different surgical methods,to evaluate therisk of hypoparathyroidism.Results:In patients with surgical treatment in755cases,105cases of symptoms ofhypocalcemia,ratio of13.9%.Occurred in male patients with symptomatic hypocalcemiaratio of9.9%,female is14.9%; Occurred in nodular goiter with symptomatic hypocalcemiaratio of7.8%,thyroid adenoma is0%, Hashimoto’s thyroiditis is4.5%, Hyperthyroidism is52.9%, Thyroid cancer is27.1%; Merge two or more of these diseases is16.1%; Occurredin initial surgery with symptomatic hypocalcemia ratio of12.1%, reoperation is28.9%;Occurred in total thyroidectomy and cervical lymph nodes dissection with symptomatichypocalcemia ratio of39.1%, total thyroidectomy is30.7%,bilateral near total or subtotalthyroidectomy is27.5%,one side total and the other side near totla or subtotal thyroidectomy is16.1%,bilateral partial thyroidectomy is6.3%,one side near total orsubtotal thyroidectomy is2.1%.Conclusion:1.Symptomatic hypoparathyroidism after thyroid surgery （bilateral subtotalthyroidectomy） is not associated with the diseases of benin or maligant(P=0.304).2．Symptomatic hypoparathyroidism after thyroid surgery（total thyroidectomy）is notassociated with the initial surgery or reoperation(P=0.389).3.Symptomatic hypoparathyroidism after thyroid surgery（total thyroidectomy andcervical lymph nodes dissection） is not associated with the initial surgery or reoperation(P=0.637)4.Bilateral partial thyroidectomy has a higher risk of the occurrence of symptomatichypoparathyroidism than one side near total or subtotal thyroidectomy（P<0.05）.5. Bilateral near total or subtotal thyroidectomy has a higher risk of the occurrence ofsymptomatic hypoparathyroidism than bilateral partial thyroidectomy（P<0.01）.6. Total thyroidectomy and cervical lymph nodes dissection has a higher risk of theoccurrence of symptomatic hypoparathyroidism than one side total and the other side neartotla or subtotal thyroidectomy（P<0.05）.