关键词: 甲状腺全切除术, 甲状旁腺功能减低, 回顾性分析

Abstract: ［Abstract］ Objective To analyze the follow?up data of patients with temporary and permanent hypoparathyroidism after total thyroidectomy， and explore the relationship between the degree of postoperative PTH reduction and the normal time of PTH recovery， providing a theoretical basis for optimization of postoperative calcium supplementation in patients with total thyroidectomy. Methods A total of 84 patients with hypoparathyroidism （PTH<1.2 pmol/l， including both temporary and permanent） who underwent total thyroidectomy in the same therapeutic group of Peking University Shenzhen Hospital thyroid surgical department were retrospectively analyzed. Among them， 4 patients were loss to follow?up. The volunteers were divided into 3 groups according to the PTH level on the first postoperative day （Group A PTH≤0.3 pmol/l， Group B 0.3 pmol/l0.05）. There was a statistically significant difference between group A and group B. The medication rate in group A was higher than that in group B （P=0.014）； There was no statistical difference in medication between group A and group C， group B and group C （P=0.093 and 0.485）. Within 1 month and within 3 months after surgery， there was a significant difference between the proportion of patients with normal recovery of PTH in each group， until the 6 months after surgery， the recovery of PTH values among the groups had no statistically significant difference （P>0.05）. There was a statistically significant difference in the postoperative recovery rate of PTH among the three groups （P=0.017）. The rank sum test was performed in two groups. Compared group A with group B， group A with group C， there were statistically significant differences in the recovery rate of PTH values （P=0.025 and 0.033）. Group B and group C recovered faster than group A. Compared group B with group C， there was no significant difference in the recovery rate of PTH （P=0.936）. Conclusion Patients with hypoparathyroidism after total thyroidectomy should be treated with oral calcium to prevent hypocalcemia. The PTH level should be reviewed within one month； PTH≤0.3 pmol/l on the first postoperative day，the recovery period islonger than those PTH>0.3 pmol/l， and there is a higher chance of permanent hypoparathyroidism. Follow?up should be closely； by the 6th month after surgery， the PTH value of different degrees can be recovered to normal.

Key words: total thyroidectomy, hypoparathyroidism, retrospective analysis