갑상선전절제술 후 일과성 및 영구적 저칼슘혈증의 위험인자 -일과성 저칼슘혈증의 주요인은 무엇인가?-

• 영문명: The Risk Factors of Hypocalcemia after Total Thyroidectomy: What is the Main Cause of Transient Hypocalcemia?
• 발행기관: 대한내분비외과학회
• 저자명: 홍석준 이정선 김연선 Suck Joon Hong M.D. Chung Seon Lee M.D. and Yon Seon Kim M.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』5권2호, 87~92쪽, 전체 6쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2005.12.30

영문 초록

Purpose: Parathyroid injury and metabolic events are known causes of post thyroidectomy hypocalcemia and many other clinical risk factors are also noted. This retrospective study was undertaken to determine the main causative factor of transient hypocalcemia after total thyroidectomy. Methods: 237 patients underwent total thyroidectomy and 10 patients underwent lobectomy were enrolled in this study. The incidence of transient and permanent hypocalcemia was investigated and we evaluate the risk factors. In 36 patients who underwent total thyroidectomy and 10 patients who underwent lobectomy, serum total calcium and, ionized calcium, i-PTH were measured at post operative day 1, 3, 7 and compared according to the number of preserved parathyroid glands. Results: The incidence of transient and permanent hypocalcemia after total thyroidectomy was 3.4% (8/237) and 0.4% (1/237) respectively. Among the investigated risk factors, the number of preserved parathyroid gland was the only significant factor for hypocalcemia and, tumor extent, extent of central lymph node dissection and, lateral lymph node dissection were not the significant risk factors. The incidence of hypocalcemia was closely related to the number of preserved parathyroid gland (0 (66.7%), 1 (5.2%), 2 (0.7%), 3 (0%), 4 (0%))(P＜0.001). The levels of serum total calcium, ionized calcium and, i-PTH were significantly different between the patients in whom only 1 parathyroid gland was preserved and more than 1 gland preserved at post operative day 1, 3. However there was no difference between two groups at post operative day 7. Conclusion: The technical aspect of parathyroid preservation is the most important factor for post thyroidectomy hypocalcemia. (Korean J Endocrine Surg 2005;5:87-92)

키워드

일과성저칼슘혈증, 위험인자, 갑상선전절제술,Transient hypocalcemia, Risk factor, Total tyroidectomy