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时间:2020-05-15
《甲状腺癌根治术中甲状旁腺自体移植的临床疗效分析.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、第36卷第5期安徽医学2015年5月AnhuiMedicalJournal613甲状腺癌根治术中甲状旁腺自体移植的临床疗效分析乐科发赵丽华洪和平张志勇[摘要]目的探讨甲状腺癌根治术中应用甲状旁腺自体移植(PAT)的临床疗效。方法选择2009年1月至2014年1月在我院行甲状腺癌根治术的患者141例,按照术中是否接受PAT分为两组。观察组63例,为接受PAT患者;对照组78例,为未接受PAT患者。比较两组术后1、2、3和7天的临床症状及体征、记录术后永久性及暂时性甲状旁腺功能低下(HP)的发生率,并与对两组术后甲状旁腺激素(PTH)水平进行比较。结果术后1、2、3和7天,观察组
2、术后PTH低下的症状主要以感觉异常、肢端麻木等轻度症状为主,重症如腕-足痉挛、面神经征、陶瑟征及焦虑较少,术后各种症状发生率明显低于对照组(P<005);观察组术后22永久性HP发生率明显低于对照组(χ=595,P<005);暂时性HP的发生率亦明显低于对照组(χ=1002,P<005);观察组术后2、3、4、12和24周的PTH水平明显高于对照组(P<005)。结论甲状腺癌根治术中应用PAT疗效显著,能够减轻患者术后的PTH低下的不良症状,且对术后HP的发生起到重要的预防作用。[关键词]甲状旁腺;甲状腺切除术;自体移植;甲状腺癌doi:10.3969/j.iss
3、n.1000-0399.2015.05.029ClinicalefficacyofautotransplantationofparathyroidglandduringthyroidcancerradicalsurgeryLeKefa,ZhaoLihua,HongHeping,etalDepartmentofOncology,thePeople'sHospitalofYangxin,Yangxin435200,China[Abstract]ObjectiveToinvestigatetheclinicalefficacyofautotransplantationofpar
4、athyroidglandduringthyroidcancerradicalsurgery.MethodsAtotalof141casesofpatientsunderwentthyroidcancerradicalsurgeryinourhospitalfromJanuary2009toJanuary2014weredividedintotwogroupsaccordingtowhetherautotransplantationofparathyroidglandwasperformedornot:namelythePATgroup(observationgroup,n
5、=63cases)andnonPATgroup(controlgroup,n=78cases);clinicalsymptomsandphysicalsignsoftwogroupswerecomparedonpostoperative1d,2d,3dand7d;incidencesofpermanentandtemporaryHPwererecordedaftersurgery,andpostoperativeparathyroidhormone(PTH)levelswerealsocompared.ResultsOnpostoperative1d,2d,3dand7d
6、,lowPTHsymptomsofobservationgroupweremainlymildsymptomsincludingparesthesiaandextremitiesnumbness;lessseveresymptomssuchaswristfootcramps,symptomsoffacialnerve,trousseausignandanxietywerefound,andincidencesofpostoperativesymptomsweresignificantlylowerthanthose2incontrolgroup(P<005);incid
7、enceofpostoperativepermanentHPinobservationgroupwasobviouslylowerthanthatincontrolgroup(χ2=5945,P<005),andincidenceoftemporaryHPwasalsosignificantlylowerthanthatofthecontrolgroup(χ=10023,P<005);PTHlevelsofobservationgroupweresignificantlyhigherthanth
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