Evaluation Of Parathyroid Function After Autotransplantation In Total Thyroidectomy

Objective: In total thyroidectomy, keeping parathyroid in the reserves and autotransplantation for clinical observation,to provide theoretical basis for the effectiveness of parathyroid autotransplantation.Methods: We elected 70 patients whose total thyroid were removed in Affiliated Hospital of Qinghai University from March 2013 to December 2014 as the observation group, divided into 2 groups, namely the observation group of 35 cases and control group 35 cases.In observation group,we clearly exposed and protected the parathyroid in total thyroidectomy, parathyroid which cut by mistake or insufficient blood supply were transplanted in the sternocleidomastoid; The control group was the total resection of thyroid, not all exposed parathyroid and in parathyroid autotransplantation.2 groups of patients in preoperative and postoperative day 1, 3, 5 and 1 month were tested Ca and PTH levels. Comparing two groups of postoperative low parathyroid function and hypocalcemia, to determine whether the transplanted parathyroid was survival and secretion function.Results: In table 3.1and3.2,two groups of patients were not different before operation,P>0.05. In table 3.3,postoperative PTH changes and increase trend in observation group was obviously better than the control group, basic fully recovered after 1 month, there was no difference in 1, 3, 5 d, after 1 month,P < 0.05, the difference was statistically significant. In table 3.5, two groups of patients with postoperative 1d and 3d were hypocalcemia association with different levels of numbness, hand and foot and mouth, which all were disappeared after 5 d. After 1 month, observation group of patients with postoperative were recovered, P < 0.05.In table 3.7,a temporary hypocalcemia in observation group of 3(8.5%), was lower than the control group of 10(28.5%), P<0.05. In table 3.8,transplanting 2 or 3 parathyroid glands, whose incidence of HP were14.2%、10.0%, significantly lower than the 54.5% incidence of 1 parathyroid gland, P < 0.05,difference was statistically significant. All of the patients postoperative symptoms of low calcium were given intravenous or oral calcium supplements, the majority of patients,symptoms were disappeared after 5 ~ 7 days,In table 3.4 and3.6,compared with the preoperative,all patients recovered after 1 month, all permanent parathyroid function were not low.Conclusion: Parathyroid autotransplantation dramatically reduce the incidence of postoperative parathyroid hypofunction. Transplanting 2 or 3 parathyroid are best and parathyroid should be cut into tissue homogenate as far as possible, such parathyroid gland will recover faster. The secretory function of parathyroid recovers within 1 month.