Thyroid Surgery Parathyroid Function Of Related Factors Analysis And Countermeasures

Objective:By understanding the effect of parathyroid function through surgical treatment on the patient of thyroid disease and the related factors which about occurrence and development of hypocalcemia after the surgery, to discuss the treatment methods and countermeasures of hypocalcemia after the surgery.Methods:Researching is based on morbidity statistics and surgery-method statistic of disease variety on 1975 surgical patients with thyroid disease. By Statistics and testing the hypoparathyroidism and changes in serum calcium values by different surgical methods and the relationship between the surgical frequency and the complications after surgery.Results:In 1975 thyroid surgery, the number of patients who occurred temporary hypocalcemia is 274among it, the incidence of bilateral total thyroidectomy is 7. The incidence of one side total thyroidectomy and the other side subtotal thyroidectomy is 194. The incidence of bilateral subtotal thyroidectomy is 55. The incidence of one side total thyroidectomy and the other side partial thyroidectomy is 8. The incidence of one side subtotal thyroidectomy is 10. The incidence of permanent hypocalcemia is 2.When hypocalcemia occurred on the patient of thyroid disease when they choose different surgery, there is a significant difference serum calcium values before and after the surgery and patients with low calcium levels occurred is most obvious after 2 days.When the patient of thyroid disease having a surgical treatment-the incidence ratio of hypoparathyroidism complication-reoperation rate was 27.9%,the occurrence of the initial surgery was 14.3%, it is significantly higher than the initial surgery.We can discover the relationship between the inferior thyroid artery ligation and the parathyroid injury in the surgery from table 6 that the incidence of complications of inferior thyroid artery ligation to induce hyperparathyroidism dysfunction in the surgery is 23.1%. But the incidence of complications of inferior thyroid artery which is not ligated to induce hypoparathyroidism dysfunction in the surgery is 8.36%. The difference is statistically significant.Conclusion:(1).The incidence of thyroid disease percentage has significant changing trends, however, goiter is still at the top.(2).When the patient of thyroid diseases having surgical treatment, the choice of removal a wider range in the surgical procedures and having two or more surgery, it is prone to hypocalcemia.(3). When the hypocalcemia occurred on the patient of thyroid diseases after the surgery, there is a most significant change in serum calcium 3 days after the surgery, especially the lowest level of serum calcium and obvious symptoms on the 2nd day.(4). The usage of sophisticated technical operations and avoiding the inferior thyroid artery ligation in the surgery can prevent and reduce postoperative hypoparathyroidism effectively.(5). From the surgical selection, the patients with bilateral subtotal thyroidectomy or above should get routine testing of serum calcium 3 days after surgery and supplement appropriate calcium.(6). For the patients undergoing thyroid surgery again, we should avoid blind operation and detect all errors. Using autologous transplantation early to avoid the occurrence of postoperative hypocalcemia.