The Changes Of Serum Parathyroid Hormone And Risk Factors Contributing To Parathyroid Hormone Deficiency After Thyroid Surgery

Objective:Parathyroid hormone (PTH) deficiency, along with hypocalcemia and bleeding, is a common complication associated with thyroidectomy. To investigate the changes and risk factors of serum parathyroid hormone(PTH) and serum calcium after thyroidectomy. Risk factors associated with differences in clinical and pathologic features were analyzed to provide appropriate surgical management.Methods:A total of184patients who received thyroid surgery in our surgery team during April2012to July2013were retrospectively reviewed.Among which51patients were diagnosed malignant and others were diagnosed benign. The serum PTH and serum calcium were detected before and on1st,3rd, and5th day after surgery, parathyroid function were evaluated dynamically after thyroid surgery.Results:Postoperative hypoparathyroidism occurred in49patients, among which24patients were diagnosed malignant and25patients were diagnosed benign. Postoperative hypocalcemia occurred in86patients, among which31patients were diagnosed malignant and55patients were diagnosed benign. Postoperative PTH levels and serum calcium levels were significantly lower in the malignant group than in the benign group (P<0.05). The most significant difference is on the first postoperative day. There was significant difference between the PTH on each time point (P<0.01).Total thyroidectomy, thyroidectomy plus neck dissection and thyroid cancer resulting in an increased incidence of hypoparathyroidism when compared with unilateral thyroid lobectomy and benign thyroid occupied lesions (P<0.01).Conclusion:Thyroid surgery may affect the secretion of PTH and cause the postoperative hypoparathyroidism, even postoperative hypocalcemia. The incidence of postoperative hypoparathyroidism and hypocalcemia were significantly lower in malignant group than benign group.The incidence of hypoparathyroidism and hypocalcemia depend on the extent of surgery. Of all risk factors, total thyroidedtomy, thyroidectomy plus neck dissection and thyroid cancer were more likely to result in postoperative hypoparathyroidism.