甲状腺全切除术对原发性甲状腺功能亢进合并甲状腺癌患者甲状旁腺激素、血钙水平的影响

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摘要目的探讨甲状腺全切除术对原发性甲状腺功能亢进合并甲状腺癌患者甲状旁腺激素（PTH）、血钙水平的影响。方法选取我院2018年2月～2019年12月收治的60例原发性甲状腺功能亢进合并甲状腺癌患者作为研究对象，按照随机数字表法分为对照组（30例）与观察组（30例）。对照组采用甲状腺次全切除术方法，观察组采用甲状腺全切除术方法。比较两组的临床指标、甲状腺激素、血钙水平、血清水平、并发症。结果两组的手术时间、术中出血量、住院时间比较，差异无统计学意义（P＞0.05）；两组术前的总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、PTH、血钙水平比较，差异无统计学意义（P＞0.05）；两组术后的TT3、TT4水平均高于术前，PTH、血钙水平低于术前，且观察组术后的TT3、TT4水平高于对照组，PTH、血钙水平低于对照组，差异有统计学意义（P＜0.05）；两组术前的白介素17（IL-17）、白介素35（IL-35）水平比较，差异无统计学意义（P＞0.05）；两组术后的IL-17水平低于术前，IL-35水平高于术前，观察组术后的IL-17水平低于对照组，IL-35水平高于对照组，差异有统计学意义（P＜0.05）；两组术后的并发症总发生率比较，差异无统计学意义（P＞0.05）。结论原发性甲状腺功能亢进合并甲状腺癌患者采用甲状腺全切除术治疗可使PTH、血钙水平降低，但其可调节炎症因子水平，并具有一定的安全性。

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关键词 ：原发性甲状腺功能亢进, 甲状腺癌, 甲状腺全切除术, 甲状旁腺激素, 血钙

Abstract：Objective To investigate the influence of total thyroidectomy on parathyroid hormone (PTH) and blood calcium levels in patients with primary hyperthyroidism and thyroid cancer.Methods A total of 60 patients with primary hyperthyroidism combined with thyroid cancer who were admitted to our hospital from February 2018 to December 2019 were selected as the research subjects.All the selected patients were divided into the control group (30 cases)and the observation group (30 cases) according to random number table method.The control group underwent subtotal thyroidectomy,and the observation group was treated with total thyroidectomy.The clinical indexes,thyroid hormone,blood calcium level,serum level and complications were compared between the two groups.Results The operation time,intraoperative bleeding volume,and hospital stays were compared between the two groups,and the differences were not statistically significant (P>0.05).The levels of total triiodothyronine (TT3),total thyroxine (TT4),PTH and blood calcium were compared between the two groups before surgery,and the differences were not statistically significant (P>0.05).The levels of TT3 and TT4 in the two groups after surgery were higher than those before surgery,the levels of PTH and blood calcium after surgery were lower than those before surgery,the levels of TT3 and TT4 in the observation group after surgery were higher than those in the control group,and the levels of PTH and blood calcium in the observation group after surgery were lower than those in the control group,and the differences were statistically significant (P<0.05).The IL-17 levels of the two groups after surgery were lower than those before operation,and the IL-35 levels of the two groups after surgery were higher than those before operation,the level of IL-17 of the observation group after surgery was lower than that of the control group,while the IL-35 level of the observation group after surgery was higher than that of the control group,and the differences were statistically significant (P<0.05).There was no statistical difference in the total incidence of postoperative complications between the two groups (P>0.05).Conclusion Total thyroidectomy in the treatment of patients with primary hyperthyroidism and thyroid cancer decreases the levels of PTH and blood calcium,but it can regulate the levels of inflammatory factors,which has certain safety.

Key words： Primary hyperthyroidism Thyroid cancer Total thyroidectomy Parathyroid hormone Blood calcium

基金资助:江西省上饶市科技指导计划项目（20143CZD08）

作者简介: 王炫凯（1985-），男，汉族，江西上饶人，本科，主治医师，研究方向：肿瘤外科（头颈乳腺外科）

引用本文:

王炫凯;李贤勇;林观毛;洪慧;李志荣;占冬仔. 甲状腺全切除术对原发性甲状腺功能亢进合并甲状腺癌患者甲状旁腺激素、血钙水平的影响[J]. 中国当代医药, 2020, 27(30): 106-109.
WANG Xuan-kai;LI Xian-yong; LIN Guan-mao; HONG Hui;LI Zhi-rong;ZHAN Dong-zai. Influence of total thyroidectomy on parathyroid hormone and blood calcium levels in patients with primary hyperthyroidism and thyroid cancer. 中国当代医药, 2020, 27(30): 106-109.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2020/V27/I30/106

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