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

摘要： ［摘要］ 目的 分析甲状腺全切术后发生暂时性及永久性甲状旁腺功能减低患者的随访资料，探讨术后PTH降低程度与PTH恢复正常时间的关系，为甲状腺全切患者术后补钙方案的优化提供理论指导。方法 回顾性分析北京大学深圳医院甲状腺外科同一治疗组行甲状腺全切除手术后出现甲状旁腺功能减低（PTH<1.2 pmol/L，包括暂时性及永久性）的患者共84例，其中4例失访，以患者术后第1天的PTH水平分为3组（A组 PTH≤0.3 pmol/L，B组 0.3 pmol/L 0.05）；A组和B组之间服药情况有统计学差异，A组服药率高于B组（P=0.014）；A组和C组、B组和C组之间服药情况无统计学差异（P=0.093和0.485）。术后1月内及3月内，各组PTH恢复正常患者所占比例组间有显著差异，直到术后6个月，各组间PTH值恢复情况已基本无统计学差异（P>0.05）。发现各组间PTH值术后恢复快慢存在统计学差异（P=0.017）。两两分组进行秩和检验，A组相比B组、A组相比C组PTH值术后恢复快慢存在统计学差异（P=0.025和0.033），B组和C组比A组恢复快。B组相比C组PTH值术后恢复快慢无统计学差异（P=0.936）。结论 甲状腺全切术后出现甲状旁腺功能减低的患者应嘱口服钙剂预防低钙血症，并应1月内复查血PTH水平为佳；术后第1天PTH≤0.3 pmol/L的患者恢复周期长，发生永久性甲状旁腺功能减低的几率大，故应密切随访；至术后6个月，不同程度降低的PTH值基本均可恢复至正常。

关键词: 甲状腺全切除术, 甲状旁腺功能减低, 回顾性分析