减重手术后接受甲状腺切除术患者的低钙血症调查

doi:10.3969/j.issn.1009-976X.2021.04.012

摘要/Abstract

摘要： 目的探讨减肥手术与甲状腺切除术后低钙血症的关系。方法检索Pubmed数据库、万方数据库和CNKI数据库相关文献,包括减肥手术、甲状腺切除术、低钙、低钙血症。在既往有减肥手术史的患者中再次接受甲状腺切除术,对低钙血症进行了调查。结果 Pubmed数据库共有16篇论文报道了 82例甲状腺切除术后低钙血症,其中66例（80.48%）患者行RYGB术,5例（6.1%）患者行SG术,6例（7.31%）患者行LAGB手术中,5名（6.1%）患者接受了BPD手术。89.02%（73例）为女性,10.98%（9例）为男性,85.36%（70例）接受了甲状腺全切除术,14.64%（12例）为甲状腺次全切除术。在提及淋巴结清扫的5篇文章中,34.69%（17/49）患者接受了淋巴结清扫术。两次手术间隔最短4个月,最长9.1年。结论之前接受过减肥手术的患者发生甲状腺切除术后低钙血症的风险很高,在RYGB和BPD患者中更为普遍。常规药物治疗对大多数低钙血症有效,但顽固的低钙血症可以通过Roux-en-Y胃肠旁路手术改善钙的吸收。

关键词: 减重手术, 甲状腺切除术, 低钙血症

Abstract: Objective To investigate the relationship between of bariatric surgery and thyroidectomy hypocalcemia. Methods Pubmed database, Wanfang database and CNKI database were searched for relatedliteratures,includding bariatric surgery,thyroidectomy, hypocalcemia, low-calciu. Hypocalcemia was investigated in the patients with previous bariatric surgeryhistory underwent thyroidectomy again. Results A total of 16 papersin Pubmed database reporting on 82 patients with hypocalcemia after thyroidectomy, in which 66（80.48%） patients with hypocalcemia underwent RYGB procedure, 5（6.1%） with hypocalcemia underwent SG procedure, 6（7.31%） with hypocalcemia underwent LAGBprocedure, 5（6.1%） with hypocalcemia underwent BPD procedure. Of these cases, 89.02% （73 cases） were females, 10.98% （9 cases） males, 85.36% （70/82）underwent total thyroidectomy, 14.64% （12/82） subtotal thyroidectomy. In the 5 articles mentioned and recorded,34.69% （17/49） patients underwent lymph node dissection. The shortest interval between two operations was 4 months, and the longest is 9.1 years. Conclusion Patients with previous bariatric surgery are at high risk of post-thyroidectomy hypocalcemia. Post-thyroidectomy hypocalcemia was found to be more prevalent in patients with previous RYGB and BPD, but not in previous LAGB and SG. Conventional drugs were effective for most hypocalcemia, but stubborn hypocalcemia could be resolved by surgery.

Key words: bariatric surgery, thyroidectomy, hypocalcemia

中图分类号:

R653

马灿业, 杨帆, 李宝金. 减重手术后接受甲状腺切除术患者的低钙血症调查[J]. 岭南现代临床外科, 2021, 21(04): 432-436.

MA Can-ye, YANG Fan, LI Bao-jin. Evidence and treatment of post-thyroidectomy hypocalcemia in patients with history of bariatric operations[J]. Lingnan Modern Clinics In Surgery, 2021, 21(04): 432-436.

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